Provider Demographics
NPI:1083173447
Name:FIELD, EVAN (MD)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:
Last Name:FIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14272 N FENTON RD
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-1544
Mailing Address - Country:US
Mailing Address - Phone:810-777-8326
Mailing Address - Fax:
Practice Address - Street 1:14272 N FENTON RD
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-1544
Practice Address - Country:US
Practice Address - Phone:810-777-8326
Practice Address - Fax:810-777-8327
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301508658207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology