| NPI Details | |
|---|---|
| NPI | 1487057790 |
| Gender | Male |
| Enumeration Date | 09/30/2014 |
| Last Updated | 09/30/2014 |
| Entity Type | Individual |
| Active | Over 2 years ago |
| Practice Location | |
|---|---|
| 2239 NE 19TH AVE PORTLAND OR, 97212-4616, US |
|
| Phone | (503) 284-0730 |
| Fax | |
| Business Location | |
|---|---|
| 2239 NE 19TH AVE PORTLAND OR, 97212-4616, US |
|
| Phone | (503) 284-0730 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207V00000X |
| License State | Mississippi |
| License Number | 07307 |
| Remove 1487057790 NPI Number | |
According to our database, William Russell Greene M.D. NPI is 1487057790, taxonomy code is 207V00000X and license number is 07307, license state is located at Mississippi. William Russell Greene M.D. physically located at 2239 Ne 19th Ave, Portland OR, 97212-4616. NPI Number William Russell Greene M.D. has the Individual type.
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1487057790 NPI number is provided on an as is basis without warranty of any kind. 1487057790 is maintained by the National Plan & Provider Enumeration System. The contents of William Russell Greene M.D. are for informational purposes only.
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