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Individual

MARVIN H GREENBAUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
501 BELMONT AVE, BALA CYNWYD, PA 19004-1302
(610) 667-4066
(610) 667-7955
Mailing address
501 BELMONT AVE, BALA CYNWYD, PA 19004-1302
(610) 667-4066
(610) 667-7955

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD026860E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0045485000
KEYSTONE
PA
01
180038454
RAILROAD MEDICARE
PA
01
2156912
AETNA
PA
01
426804
BLUE SHIELD
PA
01
AMERIHEALTH
0045485000
PA
Enumeration date
08/23/2006
Last updated
09/22/2010
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