Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | D61045 | MD |
N | 208000000X | Pediatrician | D61045 | MD |
NPI | 1003850058 |
---|---|
Provider Name | Carol L Greene |
First Address | Baltimore, MD 21264-2063 |
Second Address | Baltimore, MD 21201-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 21/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
793004601 | (05) | MD |
C67213 | (02) |