Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | MD-48425 | IA |
Y | 207RP1001X | Pulmonary Disease | MD-48425 | IA |
NPI | 1073909545 |
---|---|
Provider Name | Dr. Anthony Louis Greco |
First Address | Des Moines, IA 50305-1475 |
Second Address | Des Moines, IA 50314-3027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2015 |
Last Update Date | 12/08/2021 |