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Individual
DR. CHARLENE M GREENE
Active
Individual
DR. CHARLENE M GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42172
WI
207Q00000X
Family Medicine Physician
5101009102
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0852200084
BCBS MI
MI
05
—
30096600
—
WI
05
—
4197165
—
MI
01
—
P00933500
RR MEDICARE
MI
Enumeration date
11/17/2005
Last updated
05/06/2019
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