| Evergreen Family Medicine, Llc | |
|
3635 Peachtree Industrial Blvd Ste 550 Duluth GA 30096-2806 | |
| (770) 545-8380 | |
| (770) 545-8383 |
| Full Name | Evergreen Family Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3635 Peachtree Industrial Blvd Ste 550, Duluth, Georgia |
| Authorized Official Name and Position | Grace Q Chai (DIRECTOR) |
| Authorized Official Contact | 7705458380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Family Medicine, Llc 3635 Peachtree Industrial Blvd Ste 550 Duluth GA 30096-2806 Ph: (770) 545-8380 | Evergreen Family Medicine, Llc 3635 Peachtree Industrial Blvd Ste 550 Duluth GA 30096-2806 Ph: (770) 545-8380 |
| NPI Number | 1588818389 |
|---|---|
| Provider Enumeration Date | 11/06/2008 |
| Last Update Date | 01/18/2023 |
| Medicare PECOS PAC ID | 7618025404 |
|---|---|
| Medicare Enrollment ID | O20090527000555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588818389 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Grace Qing Chai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043258551 PECOS PAC ID: 8820097553 Enrollment ID: I20061207000063 |
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