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Individual
JEFFERY GREEN
Active
Individual
JEFFERY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42651
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007R5GR
BCBS
MN
05
—
007R5GR
—
MN
01
—
01-13052
MEDICA
MN
01
—
1053638
ARAZ
MN
05
—
150697
—
FM
01
—
20227
SIOUX VALLEY
MN
05
—
3153445
—
MN
05
—
398640300
—
MN
01
—
A037
CHAMPUS
MN
01
—
HP30910
HEALTH PARTNERS
MN
01
—
MH9041024627
PPO
MN
Enumeration date
12/06/2005
Last updated
09/17/2020
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