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Individual

MR. EVAN W. TAXIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
910 FREDERICK RD, CATONSVILLE, MD 21228-4516
(410) 644-1880
(410) 646-3623
Mailing address
910 FREDERICK RD, CATONSVILLE, MD 21228-4516
(410) 644-1880
(410) 644-0971

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C06231
MD
363AS0400X
Surgical Physician Assistant
Primary
C06231
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2111113413
GA
Enumeration date
12/10/2013
Last updated
01/08/2020
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