MEDICARE: NATALIE S 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	207R00000X	Internal Medicine Physician	35097666	OH

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

General Provider Information

NPI Number	:	1487830527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE S EVANS M.D.

Provider Business Mailing Address
First Line	:	11100 EUCLID AVE
Second Line	:	LKS 5038
City	:	CLEVELAND
State	:	OH
Zip	:	44106-5038
Country	:	US
Telephone Number	:	440-214-8230
Fax Number	:	216-201-5108

Provider Business Practice Location Address
First Line	:	13207 RAVENNA RD
Second Line	:
City	:	CHARDON
State	:	OH
Zip	:	44024
Country	:	US
Telephone Number	:	216-844-3800
Fax Number	:

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

Provider Enumeration Date	:	01/19/2008
Last Update Date	:	12/05/2020

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