Individual
CHARLES WILLIAM GREENE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
534 WOODS LAKE RD, GREENVILLE, SC 29607-2778
(864) 720-2739
(864) 720-2740
Mailing address
534 WOODS LAKE RD, GREENVILLE, SC 29607
(864) 720-2739
(864) 720-2740
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
17998
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179988
—
SC
01
—
5296584
AETNA
SC
01
—
576007863127
BLUE CHOICE OF SC
SC
01
—
576007863131
BCBS OF SC
SC
01
—
9212323
CIGNA
SC
Enumeration date
05/05/2006
Last updated
06/18/2018
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