MEDICARE: DR. LEONARD E. 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	208600000X	Surgery Physician	MD019805E	PA

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	:	1588666416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD E. EVANS M.D.

Provider Business Mailing Address
First Line	:	5200 CENTRE AVE
Second Line	:	SUITE 604
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-1300
Country	:	US
Telephone Number	:	412-681-4989
Fax Number	:	412-681-5117

Provider Business Practice Location Address
First Line	:	5200 CENTRE AVE
Second Line	:	SUITE 604
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-1300
Country	:	US
Telephone Number	:	412-681-4989
Fax Number	:	412-681-5117

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	07/19/2007

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