Provider Demographics
NPI:1235704610
Name:EVANS, TREVOR RYAN (DO)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:RYAN
Last Name:EVANS
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:SUITE J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:THIMG PRIMARY CARE-SOUTHEAST LIVONIA
Practice Address - Street 2:29370 PLYMOUTH RD SUITE 100
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150
Practice Address - Country:US
Practice Address - Phone:734-655-8200
Practice Address - Fax:734-655-8210
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2024-07-08
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Provider Licenses
StateLicense IDTaxonomies
MI5151014984207Q00000X
MI5101027270207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine