Individual
DR. BRUCE W EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4550 INVESTMENT DR, STE 100, TROY, MI 48098
(248) 265-4611
(248) 265-4645
Mailing address
4100 PARK FOREST DR, STE 210, TRAVERSE CITY, MI 49684-7306
(248) 265-4611
(248) 265-4645
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301041955
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1763068-10
—
MI
Enumeration date
07/25/2006
Last updated
02/04/2016
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