Individual
STEPHEN JOHN EVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7645 MARKET ST, SUITE 200, BOARDMAN, OH 44512-6098
(330) 707-0771
Mailing address
7645 MARKET ST, SUITE 200, BOARDMAN, OH 44512-6098
(330) 707-0771
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35067701
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0270264
—
OH
01
—
311549684
OHIO BWC
OH
Enumeration date
02/07/2006
Last updated
02/05/2016
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