Individual
DR. MICHAEL RICHARD GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1490 E FOREMASTER DR, # 260, ST GEORGE, UT 84790-4488
(435) 688-0156
(435) 688-0330
Mailing address
1490 E FOREMASTER DR, SUITE 260, ST GEORGE, UT 84790-4488
(435) 688-0156
(435) 688-0330
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
95-875021205
UT
Other
Enumeration date
06/14/2006
Last updated
06/09/2010
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