MEDICARE: BRUCE KEVIN GREENBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	17260	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	550775750	OTHER		TAX ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043208911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE KEVIN GREENBERG MD

Provider Business Mailing Address
First Line	:	200 CORPORATE BLVD
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508
Country	:	US
Telephone Number	:	800-893-9698
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 FAIRVIEW HEIGHTS RD
Second Line	:
City	:	SUMMERSVILLE
State	:	WV
Zip	:	26651-1085
Country	:	US
Telephone Number	:	304-872-5090
Fax Number	:	304-872-0636

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2005
Last Update Date	:	04/21/2022

Similar Medicare Providers

1336137702 — FAIRVIEW HEALTH ASSOCIATES INC
Practice Location Address:

350 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV
26651-1085

Practice Phone: 304-872-5090
Practice Fax: 304-872-0636

1659369510 — SUNITA PHASGE GREENBERG MD
Practice Location Address:

350 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV
26651-1085

Practice Phone: 304-872-5090
Practice Fax: 304-872-0636

1235128083 — MARK LYNWOOD WANTZ MD
Practice Location Address:

350 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV
26651-1085

Practice Phone: 304-872-5090
Practice Fax: 304-872-0636

1366431900 — MARGARET SUZANNE WANTZ MD
Practice Location Address:

350 FAIRVIEW HEIGHTS RD
SUMMERSVILLE, WV
26651-1085

Practice Phone: 304-872-5090
Practice Fax: 304-872-0636

1497697692 — JODY LYNN NELSON
Practice Location Address:

1205 BROAD ST
SUMMERSVILLE, WV
26651-1805

Practice Phone: 304-872-1162
Practice Fax:

1225970106 — DR. JAYSON JUDE ZIOLKOWSKI PHARM.D.
Practice Location Address:

415 MAIN ST
SUMMERSVILLE, WV
26651-1343

Practice Phone: 304-872-1663
Practice Fax:

Directions to “ BRUCE KEVIN GREENBERG MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.