Individual
MICHAEL RICHARD EVANKOVICH
Active
Individual
MICHAEL RICHARD EVANKOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD060400L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00025198402
UNIVERA
NY
05
—
0017973700003
—
PA
01
—
02079629
NY MEDICAL ASSISTANCE
NY
01
—
1041777
GATEWAY
PA
01
—
1278964
AETNA
PA
01
—
182151
UNISON
PA
01
—
212543
UPMC
PA
01
—
261978
BLUE SHIELD
PA
01
—
2662659
OH MEDICAL ASSISTANCE
OH
01
—
P00324768
RR MEDICARE
PA
Enumeration date
05/31/2006
Last updated
10/01/2020
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