Bruce W Evans, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

4301041955 Issued in MI

Practice address

4550 Investment Dr
Ste 100
Troy, MI 48098

Phone

(248) 265-4611

Fax

(248) 265-4645

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Superior Anesthetists Associates, Inc.

  • Specialist
  • Troy, MI
  • NPI 1831144518
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1972526879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 PARK FOREST DR",
            "address_2": "STE 210",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847306",
            "telephone_number": "248-265-4611",
            "fax_number": "248-265-4645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 INVESTMENT DR",
            "address_2": "STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48098",
            "telephone_number": "248-265-4611",
            "fax_number": "248-265-4645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "BRUCE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301041955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1763068-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Jo Ethier, MA, LLPC
• Nicole Claudine Ethier, LPC
• Emma L Eurich
• Kianna Eurick-Bering, MD
• Angelia Evangelista
• Diamond Evans, RBT
• Valerie J Evans, MA, LPC
• Evecon Inc
• Dajae Everette
• Evergreen Home Care LLC

• Anesthesiology Physician in Troy, MI
• Providers in Troy, MI by specialty
• Anesthesiology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.