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Individual

ALEXANDER R GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD MPH

Contact information

Practice address
15 PARKMAN ST, WAC 6, BOSTON, MA 02114-2696
(617) 724-0909
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION INC, CHARLESTOWN, MA 02129-9142
(617) 724-0909
(617) 724-3843

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
219265
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2027402
MA
01
J26925
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/04/2005
Last updated
08/13/2012
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