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General NPI Number Information
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NPI Number | 1801850862
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Entity Type | Individual
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Provider Name | ROGER ANTHONY EVANS MD
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Gender | Male
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Dates
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Enumeration Date | 04/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 17 OLD ROLLINSFORD RD SUITE 3
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City | DOVER
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State | NH
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Zip | 03820-2833
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Country | US
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Telephone | 603-742-5011
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Fax | 603-742-3530
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Provider Business Mailing Address
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Address Line | 15 LAUREL LN
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City | DURHAM
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State | NH
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Zip | 03824-3131
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Country | US
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Telephone | 603-868-2451
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 5938
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License Number State | NH
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