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General NPI Number Information
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NPI Number | 1760451850
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Entity Type | Individual
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Provider Name | CHRISTOPHER J. EVANICH M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 02/25/2020
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Provider Practice Location Address
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Address Line | 3237 S 16TH ST SUITE 210
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City | MILWAUKEE
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State | WI
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Zip | 53215-4526
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Country | US
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Telephone | 414-384-6700
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Fax | 414-384-3008
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Provider Business Mailing Address
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Address Line | 3077 N MAYFAIR RD STE 305
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City | WAUWATOSA
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State | WI
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Zip | 53222-4305
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Country | US
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Telephone | 414-384-6700
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Fax | 414-727-1058
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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 | 32282
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License Number State | WI
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