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Individual

DR. BRUCE D GREENWALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-8731
(410) 328-8315
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-8731
(410) 328-8315

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
D39961
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
037547900
DC
05
1801842018
DE
05
2000614000
WV
05
499101000
MD
01
527760-02 & 01
BLUE CROSS/BLUE SHIELD
MD
05
5851807
VA
Enumeration date
05/26/2006
Last updated
11/15/2010
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