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Individual

DANIEL A EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 N MEDICAL DR, SALT LAKE CITY, UT 84113-1103
(801) 993-9551
(801) 733-5872
Mailing address
1954 FORT UNION BLVD STE 111, SALT LAKE CITY, UT 84121-6893

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4939488-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0060758
MT
01
1021320001
CIGNA
UT
01
107012191101
IHC
UT
01
28040
HEALTHY U
UT
01
49394881200001
BCBS
UT
01
656108
DESERET MUTUAL
UT
01
68248
PEHP
UT
01
870280408EV1
EDUCATORS MUTUAL
UT
01
PRA07384
MOLINA
UT
01
QM0000057307
ALTIUS
UT
Enumeration date
08/23/2006
Last updated
07/08/2007
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