Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | E-11528 | AR |
N | 208600000X | Surgeon | E-11528 | AR |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | E-11528 | AR |
NPI | 1104076439 |
---|---|
Provider Name | Lawrence Edward Greiten |
First Address | Little Rock, AR 72202-3500 |
Second Address | Little Rock, AR 72202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2008 |
Last Update Date | 22/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ENROLLED | (05) | IA |
ENROLLED | (05) | MN |