Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | D0021428 | MD |
NPI | 1114005097 |
---|---|
Provider Name | Linda D Green |
First Address | Mount Rainier, MD 20712-1650 |
Second Address | Cheverly, MD 20785-1189 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
745187300 | (05) | MD |
C88662 | (02) |