Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 31577 | MN |
N | 111NI0900X | Internist | 31577 | MN |
N | 207RH0000X | Hematologist | 31577 | MN |
Y | 207RX0202X | Medical Oncology | 31577 | MN |
NPI | 1386670297 |
---|---|
Provider Name | Dr. Edward William Greeno |
First Address | Minneapolis, MN 55455 |
Second Address | Minneapolis, MN 55455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 19/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1010305 | PREFERRED ONE (01) | MN |
103718 | UCARE (01) | MN |
13G49GR | BCBS (01) | MN |
36-00269 | MEDICA CHOICE & PRIMARY (01) | MN |
818932 | ARAZ (01) | MN |
889263600 | (05) | MN |
F59484 | (02) | MN |
HP16307 | HEALTHPARTNERS (01) | MN |