Healthcare Provider Details
I. General information
NPI: 1750558474
Provider Name (Legal Business Name): EVAN LLEWELLYN GUTHRIE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/12/2008
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
525 LONG POND DR
HARWICH MA
02645-1227
US
IV. Provider business mailing address
525 LONG POND DR
HARWICH MA
02645-1227
US
V. Phone/Fax
- Phone: 508-430-3322
- Fax: 508-430-3387
- Phone: 508-430-3322
- Fax: 508-430-3387
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD445429 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 1022303 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: