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Contact Information

EVERGREEN GYNECOLOGY ASSOCIATES, P.A.
700 MOUNT HOPE AVE
SUITE 430
BANGOR, ME04401-5691
 Phone: 207-947-8658
 Fax: 207-947-4440
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gynecology

207VG0400X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for EVERGREEN GYNECOLOGY ASSOCIATES PA · (Female)

NPI # 1629154463
Status Active
Credentials
Entity Individual
Enumeration date 10/27/2006
Last updated 10/16/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • ME License # 011478
  • ME Medicaid 115880000
  • ME Other 726446 AETNA
  • ME Other 000697 ANTHEM
  • ME Other M63911 CIGNA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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