Individual
DR. JOHN L GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 YADKIN ST, ALBEMARLE, NC 28001-3441
(704) 984-4385
Mailing address
PO BOX 2060, ALBEMARLE, NC 28002-2060
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13804
BCBS OF NC
NC
05
—
5900012
—
NC
01
—
P00204858
RAILROAD MEDICARE
—
Enumeration date
06/17/2005
Last updated
11/12/2007
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