Individual
DR. EDWARD M. GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1199 PRINCE AVE, ATHENS, GA 30606-2797
(706) 354-5770
(706) 354-5769
Mailing address
PO BOX 5719, ATHENS, GA 30604-5719
(706) 354-5770
(706) 354-5769
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
062112
GA
207P00000X
Emergency Medicine Physician
133957
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
485331458A
—
GA
Enumeration date
03/05/2007
Last updated
12/22/2009
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