Individual
JAMES J GREENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-0535
Mailing address
N2950 STATE ROAD 67, LAKE GENEVA, WI 53147-2655
(262) 245-0535
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-087181
IL
208600000X
Surgery Physician
Primary
53948
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01619787
BCBSIL GROUP NUMBER
—
05
—
036087181
—
IL
01
—
GREENJAM
MERCYCARE INSURANCE
WI
Enumeration date
10/21/2005
Last updated
09/29/2011
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