Individual
MICHAEL GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 4TH AVE APT 14G, NEW YORK, NY 10003-4922
(352) 262-9265
Mailing address
145 4TH AVE APT 14G, NEW YORK, NY 10003-4922
(352) 262-9265
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
052730
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269162100
—
FL
01
—
37591
BCBS
FL
05
—
773158130A
—
GA
Enumeration date
06/02/2006
Last updated
07/02/2009
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