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Individual

MR. MICHAEL V. GREENWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3950 KRESGE WAY, STE 207, LOUISVILLE, KY 40207-4637
(502) 893-0220
(502) 893-0563
Mailing address
PO BOX 950296, LOUISVILLE, KY 40295-0296
(502) 893-0220
(502) 893-0563

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
207RG0100X
KY
207RG0100X
Gastroenterology Physician
Primary
24686
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64246861
KY
Enumeration date
06/20/2005
Last updated
08/26/2014
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