| Evergreen Health Care | |
|
9710 Patuxent Woods Dr Suite 200 Columbia MD 21046-1526 | |
| (301) 575-8080 | |
| Not Available |
| Full Name | Evergreen Health Care |
|---|---|
| Speciality | Family Medicine |
| Location | 9710 Patuxent Woods Dr, Columbia, Maryland |
| Authorized Official Name and Position | Jessica L 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 Rd Suite 1 Baltimore MD 21211-2474 Ph: () - | Evergreen Health Care 9710 Patuxent Woods Dr Suite 200 Columbia MD 21046-1526 Ph: (301) 575-8080 |
| NPI Number | 1033517255 |
|---|---|
| Provider Enumeration Date | 12/22/2014 |
| Last Update Date | 01/05/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033517255 | NPI | - | NPPES |
| 5354021 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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