Individual
BOB H GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4303 MICHIGAN AVE, MANITOWOC, WI 54220-3066
(920) 320-4300
(920) 684-5146
Mailing address
PO BOX 2290, MANITOWOC, WI 54221-2290
(920) 320-2840
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
40942
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32563300
—
WI
Enumeration date
09/25/2006
Last updated
06/03/2008
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