MEDICARE: DR. STEVEN D EVANS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	6749	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	323626	OTHER	AZ	AHCCCS

General Provider Information

NPI Number	:	1669442331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN D EVANS M.D.

Provider Business Mailing Address
First Line	:	1930 VILLAGE CENTER CIRCLE
Second Line	:	SUITE #3-999
City	:	LAS VEGAS
State	:	NV
Zip	:	89134
Country	:	US
Telephone Number	:	702-438-3400
Fax Number	:	702-294-0700

Provider Business Practice Location Address
First Line	:	1930 VILLAGE CENTER CIRCLE
Second Line	:	SUITE #3-999
City	:	LAS VEGAS
State	:	NV
Zip	:	89134
Country	:	US
Telephone Number	:	702-438-3400
Fax Number	:	702-294-0700

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	11/08/2012

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