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General NPI Number Information
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NPI Number | 1215965405
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Entity Type | Individual
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Provider Name | PETER JOHN EVANS MD, PHD, FAAOS
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 2150 SE SALERNO RD STE 110
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City | STUART
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State | FL
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Zip | 34997-6572
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Country | US
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Telephone | 772-781-2735
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Fax | 727-781-2739
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Provider Business Mailing Address
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Address Line | 2100 SE SALERNO RD
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City | STUART
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State | FL
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Zip | 34997-6503
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Country | US
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Telephone | 772-223-5700
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Fax | 727-223-5709
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 35079068E
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 143787
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License Number State | FL
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