| Evergreen Primary Care Pllc | |
|
1337 Wilderness Run Dr Eagan MN 55123-1856 | |
| (612) 817-7240 | |
| Not Available |
| Full Name | Evergreen Primary Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1337 Wilderness Run Dr, Eagan, Minnesota |
| Authorized Official Name and Position | Shary Vang (MEMBER) |
| Authorized Official Contact | 6128177240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Primary Care Pllc 1337 Wilderness Run Dr Eagan MN 55123-1856 Ph: () - | Evergreen Primary Care Pllc 1337 Wilderness Run Dr Eagan MN 55123-1856 Ph: (612) 817-7240 |
| NPI Number | 1831768704 |
|---|---|
| Provider Enumeration Date | 06/23/2021 |
| Last Update Date | 06/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831768704 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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