Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 18523 | SC |
NPI | 1063656924 |
---|---|
Provider Name | Dr. William Michael Greene |
First Address | Greenville, SC 29605 |
Second Address | Greenville, SC 29605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2009 |
Last Update Date | 20/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G264554202 | (02) | SC |
T25960 | (05) | SC |