Individual
MICHAEL KEITH GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28811
SC
208000000X
Pediatrics Physician
TL28811
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20056179
FIRST CHOICE
SC
05
—
288110
—
SC
01
—
576008010-013
BCBS
SC
01
—
7013843
CIGNA
SC
01
—
7245906
AETNA
SC
Enumeration date
07/11/2006
Last updated
01/12/2021
Update your record
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