Individual
LISE M GREENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
103 BATA BLVD STE A, BELCAMP, MD 21017
(410) 575-6611
(410) 367-2141
Mailing address
9910 FRANKLIN SQUARE DR # 2110, BALTIMORE, MD 21236-4902
(410) 933-5412
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0057137
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15185
HEALTHNET
—
01
—
2683650
AETNA HMO
—
01
—
522338017
MHIP
—
05
—
698201800
—
MD
01
—
7132271
AETNA PPO
—
01
—
813176
MAMSI
—
01
—
K582
MPOS
—
01
—
KJ15GB/611506-03
CAREFIRST MARYLAND
MD
01
—
KJ15GB/P18428
CAREFIRST MPOS-GBMC
MD
01
—
S138-0163
CAREFIRST REGIONAL GBMC
MD
01
—
W647001U
BLUE CHOICE
—
Enumeration date
01/05/2006
Last updated
06/05/2018
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