Individual
JAMES GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1631 HOSPITAL DR # 150, SANTA FE, NM 87505
(505) 988-2215
(505) 984-0373
Mailing address
1631 HOSPITAL DR # 150, SANTA FE, NM 87505-4728
(505) 988-2215
(505) 984-0373
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
89-205
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
800521003
MEDICARE GROUP PTAN
—
Enumeration date
08/25/2006
Last updated
08/09/2018
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