Individual
DR. JONATHAN M GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
660 S EUCLID AVE, SAINT LOUIS, MO 63110-1010
(314) 454-8917
(314) 362-8987
Mailing address
660 S EUCLID AVE, C B 8052, SAINT LOUIS, MO 63110-1010
(314) 454-8917
(314) 362-8987
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
109780
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208248906
—
MO
Enumeration date
07/05/2006
Last updated
01/24/2018
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