Individual
THOMAS E. GREEN
Active
Individual
THOMAS E. GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02002714A
IN
207P00000X
Emergency Medicine Physician
036110102
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200401690
—
IN
01
—
90001358
BSBSIL
IL
Enumeration date
09/02/2005
Last updated
04/01/2009
Update your record
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