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Individual

JENNIFER A GREENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
146 E HOSPITAL DR STE 240, WEST COLUMBIA, SC 29169-4800
(803) 936-7590
(803) 936-7589
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2006-01311
NC
207V00000X
Obstetrics & Gynecology Physician
Primary
26413
SC
207VM0101X
Maternal & Fetal Medicine Physician
2006-01311
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10410533
VA
01
143EJ
BCBS
01
191437
MEDCOST
05
3810008109
WV
05
5904789
NC
01
7679888
AETNA
01
808445
PARTNERS
Enumeration date
08/20/2006
Last updated
01/17/2023
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