Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 4301113814 | MI |
N | 207QA0401X | Family Doctor - Addiction Medicine | 4301113814 | MI |
NPI | 1144562968 |
---|---|
Provider Name | Dr. Eric Jacob Greenberg |
First Address | Royal Oak, MI 48067-1964 |
Second Address | Royal Oak, MI 48067-1964 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2013 |
Last Update Date | 26/10/2020 |