MEDICARE: MICHAEL ALAN 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	2084P0800X	Psychiatry Physician	5523	NH
2	2084P0804X	Child & Adolescent Psychiatry Physician	5523	NH
3	2084P0805X	Geriatric Psychiatry Physician	5523	NH

General Provider Information

NPI Number	:	1902895402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ALAN EVANS MD

Provider Business Mailing Address
First Line	:	PO BOX 7235
Second Line	:
City	:	LACONIA
State	:	NH
Zip	:	03247-7235
Country	:	US
Telephone Number	:	603-528-2573
Fax Number	:	603-528-2558

Provider Business Practice Location Address
First Line	:	25 COUNTRY CLUB RD
Second Line	:
City	:	GILFORD
State	:	NH
Zip	:	03249-6972
Country	:	US
Telephone Number	:	603-528-2573
Fax Number	:	603-528-2558

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	09/11/2025

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