Individual
DR. STEPHEN LLOYD GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2131 S BONITO WAY, MERIDIAN, ID 83642-1659
(208) 489-9500
Mailing address
26 TOWN CENTER WAY # 704, HAMPTON, VA 23666-1999
(757) 771-8049
(757) 851-1285
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
0101028335
VA
208M00000X
Hospitalist Physician
Primary
M-10266
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006069479
—
VA
01
—
1013986579
NPI CORPORATION
VA
01
—
1477679496
NPI INDIVIDUAL
VA
01
—
M-10266
IDAHO LIC
ID
Enumeration date
03/21/2007
Last updated
02/22/2013
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