Organization
LAWRENCE J GREEN, MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE J GREEN MD (PHYSICIAN)
(301) 610-0663
Entity
Organization
Contact information
Practice address
15005 SHADY GROVE RD, SUIE 440, ROCKVILLE, MD 20850-6340
(301) 610-0663
(301) 610-5420
Mailing address
15005 SHADY GROVE RD, SUITE 440, ROCKVILLE, MD 20850-6340
(301) 610-0663
(301) 610-5420
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
D50346
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
258278
MAMSI/OPTIMUM CHOICE
MD
01
—
4281-0001
BCBS
MD
01
—
5802523
AETNA
MD
Enumeration date
08/13/2006
Last updated
12/30/2009
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