Individual
DR. EVAN EDMUND HUSTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-9837
Mailing address
134 LAKE VIEW DRIVE, MEDIA, PA 19063
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MA08940200
NJ
207P00000X
Emergency Medicine Physician
MT193861
PA
Other
Enumeration date
06/30/2008
Last updated
08/15/2016
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