Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D021545 | MD |
NPI | 1154322238 |
---|---|
Provider Name | Jay B Greenberg |
First Address | Hagerstown, MD 21740-5852 |
Second Address | Hagerstown, MD 21740-5852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 13/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
788821000 | (05) | MD |
D76487 | (02) |