Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35049964 | OH |
Y | 208600000X | Surgeon | 35049964 | OH |
N | 2082S0105X | Plastic Hand Surgeon | 35049964 | OH |
NPI | 1831280213 |
---|---|
Provider Name | Dr. Rodney Allan Green |
First Address | Cleveland Heights, OH 44118-0554 |
Second Address | Lyndhurst, OH 44124-2688 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 16/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0659836 | (05) | OH |
A17051 | (02) | OH |