Individual
MICHAEL GREENE
Active
Individual
MICHAEL GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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