Individual
MR. ROBERT B EVANS
Active
Individual
MR. ROBERT B EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
0001-01419
NC
363AS0400X
Surgical Physician Assistant
517
GA
363AS0400X
Surgical Physician Assistant
Primary
PA-052
TN
363AS0400X
Surgical Physician Assistant
PA04435
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142872100
FIRST CARE
TX
01
—
4190330
BLUECROSS BLUESHIELD
TN
01
—
4190702
BLUECROSS BLUESHIELD-ASSISTANT AT SURGERY
TN
01
—
8N8208
BCBS
TX
05
—
PENDING
—
TN
Enumeration date
08/21/2006
Last updated
08/18/2009
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