Organization
EVERGREEN PRIMARY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARY VANG MD (MEMBER)
(612) 817-7240
Entity
Organization
Contact information
Practice address
1337 WILDERNESS RUN DR, EAGAN, MN 55123-1856
(612) 817-7240
Mailing address
1337 WILDERNESS RUN DR, EAGAN, MN 55123-1856
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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