MEDICARE: DR. MARY A GREENE-MCINTYRE M.D., M.P.H, SSBB

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	2083P0901X	Public Health & General Preventive Medicine Physician	12877	AL
2	251K00000X	Public Health or Welfare Agency	12877	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12377	OTHER	AL	LICENSE NUMBER

General Provider Information

NPI Number	:	1235146069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY A GREENE-MCINTYRE M.D., M.P.H, SSBB

Provider Business Mailing Address
First Line	:	201 MONROE STREET RSA TOWER STE 1466
Second Line	:	P.O. BOX 303017
City	:	MONTGOMERY
State	:	AL
Zip	:	36130-3017
Country	:	US
Telephone Number	:	334-206-5325
Fax Number	:	334-206-0354

Provider Business Practice Location Address
First Line	:	201 MONROE STREET RSA TOWER STE 1466
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36130-3017
Country	:	US
Telephone Number	:	334-206-5325
Fax Number	:	334-206-0354

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

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	03/07/2023

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