Individual
JAYSON SCOTT GREENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7500 CHALLIS RD, 1ST FLOOR, BRIGHTON, MI 48116-9416
(810) 263-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301078781
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0403811832
BLUE CROSS
MI
01
—
10-20013
PHYSICIAN HEALTH PLAN UHC
MI
05
—
4405491-10
—
MI
Enumeration date
06/30/2006
Last updated
12/13/2018
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