Organization
MARK J. GREENBAUM, D.P.M., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK J. GREENBAUM D.P.M. (PRESIDENT/PHYSICIAN)
(770) 279-2900
Entity
Organization
Contact information
Practice address
1835 SAVOY DR STE 200, ATLANTA, GA 30341-1073
(770) 279-2900
Mailing address
1835 SAVOY DR STE 200, ATLANTA, GA 30341-1073
(770) 279-2900
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000611
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00412068A
—
GA
Enumeration date
07/30/2007
Last updated
01/31/2020
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