Individual
DR. AKIDA JAMAL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
298 MEMORIAL DR, SENECA, SC 29672-9443
(864) 885-7758
(864) 885-7749
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
TL37290
SC
208M00000X
Hospitalist Physician
Primary
37290
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372901
—
SC
01
—
P01538677
RR MEDICARE
SC
Enumeration date
03/29/2007
Last updated
10/04/2022
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