Individual
DR. DERRICK LAMONT GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 HARVARD ST SE, MINNEAPOLIS, MN 55455-0363
(612) 273-3000
(612) 273-4370
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
53899
MN
Other
Enumeration date
04/10/2008
Last updated
03/17/2018
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