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NPI Code Detail

MEDICARE: TODD GREENBERG MD

MEDICARE: TODD 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
12085R0202XDiagnostic Radiology PhysicianM0739TX
22085R0202XDiagnostic Radiology Physician0053167CO
32085R0202XDiagnostic Radiology PhysicianMD00042413WA
42085R0202XDiagnostic Radiology Physician31555AZ
52085R0202XDiagnostic Radiology Physician38341KY
62085R0202XDiagnostic Radiology Physician35-077845OH
72085R0202XDiagnostic Radiology PhysicianMD25383OR
82085R0202XDiagnostic Radiology PhysicianMD24573ME

Other Identifiers

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

General Provider Information

NPI Number : 1063410421
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD GREENBERG MD
Provider Business Mailing Address
First Line : 324 GANNETT DR STE 200
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-3266
Country : US
Telephone Number : 207-482-7800
Fax Number :
Provider Business Practice Location Address
First Line : 489 STATE ST
Second Line :
City : BANGOR
State : ME
Zip : 04401-6616
Country : US
Telephone Number : 207-482-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 04/23/2021

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Directions to “ TODD GREENBERG MD” Practice Location

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