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Individual

MICHAEL KEITH GREENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 E WOOD ST STE 401, SPARTANBURG, SC 29303-3040
(864) 560-6654
(864) 560-7353
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413

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
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