Provider Demographics
NPI:1457931115
Name:GREENBERG, HANNAH NICOLE (DO)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:NICOLE
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:804 SERVICE RD STE A202
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-353-4000
Mailing Address - Fax:517-353-4001
Practice Address - Street 1:13750 S SEDONA PKWY STE 2
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-8101
Practice Address - Country:US
Practice Address - Phone:517-353-4000
Practice Address - Fax:844-722-4112
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101028051208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics