Individual
MARY K GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1873
(937) 689-9117
(937) 431-8562
Mailing address
PO BOX 3123, INDIANAPOLIS, IN 46206-3123
(800) 901-2959
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
35064945
OH
2085R0202X
Diagnostic Radiology Physician
51547
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2417352
—
OH
Enumeration date
11/18/2005
Last updated
09/27/2013
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