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Individual

EDWARD DAVID GREENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2722 MERRILEE DR, STE 230, FAIRFAX, VA 22031-4420
(703) 698-4444
(703) 204-0116
Mailing address
2722 MERRILEE DR, STE 230, FAIRFAX, VA 22031-4420
(703) 698-4444
(703) 204-0116

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101251267
VA
2085R0204X
Vascular & Interventional Radiology Physician
0101251267
VA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0101251267
MEDICAL LICENSE
VA
01
0123
CAREFIRST BCBS
VA
05
3810023115
WV
01
60 241311
NY STATE MEDICAL LICENSE NUMBER
NY
01
8442961
AETNA HMO
VA
01
9188852
AETNA PPO
VA
Enumeration date
10/10/2008
Last updated
08/16/2012
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