Individual
MARIA ETHEL EVALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
299 CAREW ST STE 126, SPRINGFIELD PEDIATRICS, SPRINGFIELD, MA 01104-2304
(413) 747-5437
(413) 747-5433
Mailing address
147 MILK ST, PROVIDER ENROLLMENT SPECIALIST, BOSTON, MA 02109-4806
(617) 559-8053
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
80970
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015186
NEIGHBORHOOD HEALTH
MA
05
—
3140423
—
MA
01
—
406094
TUFTS
MA
01
—
J16171
BLUE CROSS
MA
01
—
PP822
HARVARD PILGRIM
MA
Enumeration date
01/27/2006
Last updated
07/08/2007
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