Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 35-064237 | OH |
NPI | 1023042389 |
---|---|
Provider Name | Douglas H Green |
First Address | Akron, OH 44302-1709 |
Second Address | Fairlawn, OH 44333-4200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 04/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1841239274 | PARTNERS PHYSICIAN GROUP TYPE 2 NPI # (01) | OH |
2551671 | PARTNERS PHYSICIAN GROUP MEDICAID GROUP # (01) | OH |
2836579 | (05) | OH |
9338635 | PARTNERS PHYSICIAN GROUP MEDICARE GROUP # (01) | OH |