| NPI | 1528023116 |
|---|---|
| Doing Business As | EVERGREEN |
| Entity Type | Organization |
| Authorized Contact | EMIL P. MISKOVSKY Owner 802-442-4785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2008-06-13 |