Provider Demographics
NPI:1124058045
Name:EVANSON, CHRISTOPHER M (MD)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:M
Last Name:EVANSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13430 N MERIDIAN ST
Mailing Address - Street 2:SUITE 275
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1405
Mailing Address - Country:US
Mailing Address - Phone:317-582-8810
Mailing Address - Fax:317-582-8863
Practice Address - Street 1:13430 N MERIDIAN ST
Practice Address - Street 2:SUITE 275
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1405
Practice Address - Country:US
Practice Address - Phone:317-582-8810
Practice Address - Fax:317-582-8863
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01055850A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00787053OtherRAILROAD MEDICARE
IN200384180Medicaid
IN200384180Medicaid
INM400074487Medicare PIN