Provider Demographics
NPI:1992790968
Name:GREENE, ELEANOR ELAINE (MD)
Entity type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:ELAINE
Last Name:GREENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3750 ADMIRAL DRIVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265
Mailing Address - Country:US
Mailing Address - Phone:336-841-6574
Mailing Address - Fax:336-841-6906
Practice Address - Street 1:3750 ADMIRAL DR STE 104
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1556
Practice Address - Country:US
Practice Address - Phone:336-841-6574
Practice Address - Fax:336-841-6906
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC30032207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8937039Medicaid
NC206782EMedicare ID - Type Unspecified
NC8937039Medicaid