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Individual

DR. RAYMOND HOWARD GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
4735 OGLETOWN STANTON ROAD, MEDICAL ARTS PAVILION 2, SUITE 3301, NEWARK, DE 19713-2067
(302) 623-4370
(856) 342-2817
Mailing address
4735 OGLETOWN STANTON RD, MAP 2, SUITE 3301, NEWARK, DE 19713-2072

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
C7-0002936
DE
2086S0102X
Surgical Critical Care Physician
Primary
C2-0011822
DE
2086S0102X
Surgical Critical Care Physician
MB08839000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MB08839000
STATE LICENSE
NJ
Enumeration date
03/13/2007
Last updated
11/29/2016
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