Individual
MICHAEL DAVID GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3700 JOSEPH SIEWICK DRIVE, SUITE 203, FAIRFAX, VA 22033-1738
(703) 758-7500
(703) 758-8316
Mailing address
3700 JOSEPH SIEWICK DRIVE, SUITE 203, FAIRFAX, VA 22033-1738
(703) 758-7500
(703) 758-8316
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101040924
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101040924
VIRGINIA LICENSE
VA
Enumeration date
09/20/2006
Last updated
07/08/2007
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