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Individual
MR. JAMES EDWARD GREEN
Active
Individual
MR. JAMES EDWARD GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA, PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601001816
MI
367H00000X
Anesthesiologist Assistant
Primary
263
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598712390
GROUP NPI
MI
01
—
M73860-008
MEDICARE
MI
01
—
P00343185
RAILROAD MEDICARE PIN
MI
Enumeration date
08/16/2006
Last updated
03/04/2013
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