Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | MD026691L | PA |
NPI | 1295719706 |
---|---|
Provider Name | Morren J Greenburg |
First Address | Sharon, PA 16146-1754 |
Second Address | Sharon, PA 16146-1754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 30/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1007298790004 | (05) | PA |
C26785 | (02) | PA |