# EVERGREEN FAMILY MEDICINE, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528164936
- **Authorized official:** DR. DAVID MICHAEL NEWMAN MD (PRESIDENT)
- **Authorized official phone:** (585) 637-0151

## Contact information

- **Practice address:** 4079 LAKE RD N, BROCKPORT, NY 14420-1517
- **Practice address phone:** (585) 637-0151
- **Practice address fax:** (585) 637-0562
- **Mailing address:** 4079 LAKE RD N, BROCKPORT, NY 14420-1517
- **Mailing address phone:** (585) 637-0151
- **Mailing address fax:** (585) 637-0562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NY | Yes |

## Other

- **Enumeration date:** 09/15/2006
- **Last updated:** 08/22/2020