Evergreen Primary Care, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

051195 Issued in GA

Legal business name

EVERGREEN PRIMARY CARE, PC

Practice address

4855 River Green Pkwy
Suite 520
Duluth, GA 30096-8336

Phone

(678) 417-1588

Fax

(678) 417-1589

NPI assigned

Jul 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Alice-Wei You, M.D.

Title

President

Phone

(678) 417-1588

Specialties & licenses 1

Addresses

Other names 1

• Duluth Family Medical Clinic Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1821297920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY",
            "address_2": "SUITE 520",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968336",
            "telephone_number": "678-417-1588",
            "fax_number": "678-417-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 RIVER GREEN PKWY",
            "address_2": "SUITE 520",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968336",
            "telephone_number": "678-417-1588",
            "fax_number": "678-417-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PRIMARY CARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "YOU",
        "authorized_official_first_name": "ALICE-WEI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-417-1588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "051195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duluth Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.