Individual
DR. IAN THOMAS GREENWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15195 HEATHCOTE BLVD STE 240, HAYMARKET, VA 20169-6245
(571) 284-3460
Mailing address
PO BOX 748613, ATLANTA, GA 30384-8613
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101283801
VA
2086X0206X
Surgical Oncology Physician
MD047318
DC
Other
Enumeration date
03/27/2014
Last updated
12/06/2024
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