Individual
DR. EVAN ROBERT MAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
STONY BROOK RADIOLOGY UFPC, HSC LEVEL 4, ROOM 120, STONY BROOK, NY 11794-8460
(631) 444-5400
(631) 444-7538
Mailing address
STONY BROOK RADIOLOGY UFPC, HSC LEVEL 4, ROOM 120, STONY BROOK, NY 11794-8460
(631) 444-5400
(631) 444-7538
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
231332
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02675607
—
NY
Enumeration date
08/30/2005
Last updated
10/23/2012
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