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Individual

DR. MICHAEL GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4100 GRAND AVE S, MINNEAPOLIS, MN 55409-1539
(612) 501-1185
Mailing address
4043 PLEASANT AVE, MINNEAPOLIS, MN 55409-1544
(612) 823-6921

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
31175
MN

Other

Enumeration date
12/15/2005
Last updated
07/08/2007
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