Organization
PRIMARY CARE OF GERMANTOWN,LC
Active
Other names
evergreen medical center, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARON XIAO-CHUN YANG MD (ATTENDING PHYSICIAN)
(240) 688-6949
Entity
Organization
Contact information
Practice address
6 EXECUTIVE PARK CT, GERMANTOWN, MD 20874-2645
(301) 515-9160
(301) 515-7388
Mailing address
6 EXECUTIVE PARK CT, GERMANTOWN, MD 20874-2645
(301) 515-9160
(301) 515-7388
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
D0061696
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150491ZDG4
MEDICARE GROUP PROVIDER NUMBER
MD
05
—
404942000
—
MD
Enumeration date
03/20/2007
Last updated
06/01/2011
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