Individual
ANDREW GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 DUDLEY ST, STE 200, PROVIDENCE, RI 02905-3236
(401) 457-1515
Mailing address
PO BOX 1119, PROVIDENCE, RI 02901-1119
(401) 457-1515
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
08413
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9020164
—
RI
Enumeration date
06/08/2006
Last updated
07/09/2014
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