Organization
ALBANY DERMATOLOGY CLINIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA F. GREENFIELD DO (PHYSICIAN)
(407) 875-2080
Entity
Organization
Contact information
Practice address
2709 MEREDYTH DR, SUITE 340, ALBANY, GA 31707-0222
(229) 883-1130
(229) 883-1153
Mailing address
151 SOUTHHALL LANE, SUITE 300, MAITLAND, FL 32751-7172
(407) 875-2080
(407) 650-3455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
049451
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300021798A
—
GA
01
—
CB2415
MEDICARE RAILROAD GROUP #
GA
01
—
GRP1577
MEDICARE SECONDARY GRP #
GA
Enumeration date
09/22/2005
Last updated
04/12/2016
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