Individual
MICHAEL WYNN EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
384 AIRPORT RD, HAZLE TOWNSHIP, PA 18202-3325
(570) 501-1242
(570) 501-1252
Mailing address
PO BOX 783311, PHILADELPHIA, PA 19178-3311
(484) 884-4500
(484) 884-0699
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
MD439423
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102618108-0003
—
PA
05
—
PENDING
—
PA
Enumeration date
10/31/2007
Last updated
02/13/2020
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