Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | ME96115 | FL |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 243815 | NY |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | ME96115 | FL |
NPI | 1205055027 |
---|---|
Provider Name | Mr. Cole Douglas Greves |
First Address | Orlando, FL 32806-1014 |
Second Address | Orlando, FL 32806-1014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 26/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0004443000 | (05) | FL |
ME96115 | MEDICAL LICENSE (01) | FL |