Individual
DR. DERRICK RICHARD GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3200 MACCORKLE AVE SE, DEPT OF PATHOLOGY, CHARLESTON, WV 25304-1297
(304) 388-5550
(304) 388-4352
Mailing address
3200 MACCORKLE AVE SE, DEPT OF PATHOLOGY, CHARLESTON, WV 25304-1297
(304) 388-5550
(304) 388-4352
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
26706
WV
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD492362C
PA
Other
Enumeration date
04/03/2013
Last updated
10/02/2025
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