Individual
RICHARD BERNARD EVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
263 FARMINGTON AVE, UCONN MEDICAL GROUP, CANCER CENTER, FARMINGTON, CT 06030-0001
(860) 679-2100
(860) 679-4815
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
044862
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1448621
—
CT
Enumeration date
06/01/2006
Last updated
08/17/2012
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