# MICHAEL A GREENE MD PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1043313430
- **Authorized official:** MICHAEL A GREENE MD PA (PRESIDENT)
- **Authorized official phone:** (301) 963-0040

## Contact information

- **Practice address:** 19640 CLUB HOUSE RD, \#410, MONTGOMERY VILLAGE, MD 20886
- **Practice address phone:** (301) 963-0040
- **Practice address fax:** (301) 840-1504
- **Mailing address:** 19640 CLUB HOUSE RD, \#410, MONTGOMERY VILLAGE, MD 20886
- **Mailing address phone:** (301) 963-0040
- **Mailing address fax:** (301) 840-1504

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 08/22/2020