Individual
LINDA SUE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
677 E MAIN ST STE B, CENTREVILLE, MI 49032-8525
(269) 467-9011
(269) 467-9511
Mailing address
701 S HEALTH PKWY, MEDICAL STAFF OFFICE, THREE RIVERS, MI 49093-8352
(269) 273-9789
(269) 273-9611
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301062677
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3525600 10
—
MI
01
—
700G560080
BCBSM
MI
Enumeration date
11/15/2005
Last updated
07/18/2011
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