Individual
GREGORY GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
960 CLAGUE RD STE 3201, WESTLAKE, OH 44145-1588
(440) 250-2070
Mailing address
960 CLAGUE RD STE 3201, WESTLAKE, OH 44145-1588
(440) 250-2070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
012826
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34012826
MEDICAL LICENSE
OH
Enumeration date
04/22/2014
Last updated
11/23/2020
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