Individual
SANDY MAX GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 N ACADEMY AVE, MC 27-75, DANVILLE, PA 17822-2775
(570) 214-1991
(570) 217-7142
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD440120
PA
207RI0011X
Interventional Cardiology Physician
MD440120
PA
Other
Enumeration date
02/26/2007
Last updated
08/18/2020
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