Evan Miller Michaelson, MD

Orthopaedic Surgery Physician · St Augustine, FL

Individual Active NPI

NPI number 1104323286

Practice location

45 Groover Loop
St Augustine, FL 32086-6548
Phone
(903) 634-0640
Fax
(904) 634-0203

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NPI record

NPI
1104323286
Entity type
Individual (Type 1)
Enumeration date
April 6, 2018
Last updated
August 27, 2026
Certified
August 27, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Orthopaedic Surgery Physician Primary 207X00000X ME181577 FL
Orthopaedic Surgery Physician 207X00000X D0101580 MD
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X D0101580 MD

Mailing address

18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone
(623) 241-8716
Fax
(480) 499-8459

Other practice locations (1)

  • 2629 Riva Rd Ste 114, Annapolis, MD 21401-7428 · (410) 573-2530

About Dr. Michaelson

Evan Miller Michaelson, MD is a healthcare provider registered in the NPI registry with the primary taxonomy Orthopaedic Surgery Physician (code 207X00000X). The practice location is 45 Groover Loop, St Augustine, FL 32086-6548. The NPI number 1104323286 was assigned on April 6, 2018 and the record was last updated on August 27, 2026.

Dr. Michaelson lists 3 licenses in the registry: #ME181577 (FL) for Orthopaedic Surgery Physician; #D0101580 (MD) for Orthopaedic Surgery Physician; #D0101580 (MD) for Sports Medicine (Orthopaedic Surgery) Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Evan Miller Michaelson, MD?

The NPI number is 1104323286.

What is the phone number of Dr. Michaelson?

The phone number listed for the practice location is (903) 634-0640.

Where is Dr. Michaelson located?

45 Groover Loop, St Augustine, FL 32086-6548.

What is the taxonomy code for Dr. Michaelson?

The primary taxonomy code is 207X00000X – Orthopaedic Surgery Physician; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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