Provider Demographics
NPI: | 1063536266 |
---|---|
Name: | DAVID S GREEN, M.D., P.C. |
Entity type: | Organization |
Organization Name: | DAVID S GREEN, M.D., P.C. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRACTICE MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | GAIL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | THOMPSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 978-369-4238 |
Mailing Address - Street 1: | 131 OLD ROAD TO 9 ACRE COR |
Mailing Address - Street 2: | SUITE 660 |
Mailing Address - City: | CONCORD |
Mailing Address - State: | MA |
Mailing Address - Zip Code: | 01742-4191 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 978-369-4238 |
Mailing Address - Fax: | 978-369-8323 |
Practice Address - Street 1: | 131 OLD ROAD TO 9 ACRE COR |
Practice Address - Street 2: | SUITE 660 |
Practice Address - City: | CONCORD |
Practice Address - State: | MA |
Practice Address - Zip Code: | 01742-4191 |
Practice Address - Country: | US |
Practice Address - Phone: | 978-369-4238 |
Practice Address - Fax: | 978-369-8323 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-03-16 |
Last Update Date: | 2011-10-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Single Specialty |