Individual
CHARLES BRUCE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
HQ USAF SG, 1780 AIR FORCE PENTAGON, WASHINGTON, DC 20330-0001
(202) 767-4766
(202) 404-7084
Mailing address
84 WESTOVER AVE SW, BOLLING AFB, DC 20032-7432
(210) 862-7592
(202) 404-7084
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G48009
CA
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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