Evergreen Health Care | |
733 W 40th St Suite 200 Baltimore MD 21211-2112 | |
(443) 451-4993 | |
Not Available |
Full Name | Evergreen Health Care |
---|---|
Speciality | Family Medicine |
Location | 733 W 40th St, Baltimore, Maryland |
Authorized Official Name and Position | Jessica Kohnen (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 4434514973 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Evergreen Health Care 3000 Falls Road Suite 1 Baltimore MD 21211-2112 Ph: (443) 963-2818 | Evergreen Health Care 733 W 40th St Suite 200 Baltimore MD 21211-2112 Ph: (443) 451-4993 |
NPI Number | 1366840589 |
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Provider Enumeration Date | 12/22/2014 |
Last Update Date | 01/05/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366840589 | NPI | - | NPPES |
5354021 | Medicaid | MD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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