Individual
DR. MITCHELL GORDON GREENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2702 NAVARRE AVE, SUITE 305, OREGON, OH 43616-3223
(419) 691-8000
(419) 693-0111
Mailing address
2702 NAVARRE AVE, SUITE 305, OREGON, OH 43616-3223
(419) 691-8000
(419) 693-0111
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34007744G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2284675
—
OH
Enumeration date
04/26/2006
Last updated
10/31/2011
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