| Evergreen Primary Care And Wellness Pc | |
|
2450 Atlanta Hwy Ste 803 Cumming GA 30040-1252 | |
| (470) 253-7944 | |
| (678) 807-6144 |
| Full Name | Evergreen Primary Care And Wellness Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2450 Atlanta Hwy Ste 803, Cumming, Georgia |
| Authorized Official Name and Position | Heather B Wanner (OWNER) |
| Authorized Official Contact | 4702537944 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Primary Care And Wellness Pc 5485 Bethelview Rd Ste 360-331 Cumming GA 30040-9735 Ph: (470) 253-7944 | Evergreen Primary Care And Wellness Pc 2450 Atlanta Hwy Ste 803 Cumming GA 30040-1252 Ph: (470) 253-7944 |
| NPI Number | 1285134999 |
|---|---|
| Provider Enumeration Date | 02/19/2018 |
| Last Update Date | 03/08/2018 |
| Medicare PECOS PAC ID | 1456613645 |
|---|---|
| Medicare Enrollment ID | O20180328001932 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285134999 | NPI | - | NPPES |
| Provider Name | Malcolm M Traxler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124013172 PECOS PAC ID: 8224926621 Enrollment ID: I20040308000885 |
| Provider Name | Heather Wanner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720235567 PECOS PAC ID: 5799819363 Enrollment ID: I20130813000559 |
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