MEDICARE: DALE GREGORY EVANS MD

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	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	35056447	OH
2	208000000X	Pediatrics Physician	35.056447	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	:	1700947314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALE GREGORY EVANS MD

Provider Business Mailing Address
First Line	:	1931 RIVER RIDGE DR
Second Line	:
City	:	SPRING VALLEY
State	:	OH
Zip	:	45370-9781
Country	:	US
Telephone Number	:	937-546-7281
Fax Number	:

Provider Business Practice Location Address
First Line	:	1931 RIVER RIDGE DR
Second Line	:
City	:	SPRING VALLEY
State	:	OH
Zip	:	45370-9781
Country	:	US
Telephone Number	:	937-546-7281
Fax Number	:

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	01/08/2026

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Directions to “ DALE GREGORY EVANS MD” Practice Location

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