Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 058961 | GA |
NPI | 1396943973 |
---|---|
Provider Name | Dr. Andrew Emmons Green |
First Address | Atlanta, GA 30374-2616 |
Second Address | Gainesville, GA 30501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2007 |
Last Update Date | 26/01/2021 |