MEDICARE: DR. MADALENE K GREENE M.D.

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	207RR0500X	Rheumatology Physician	D38031	MD

General Provider Information

NPI Number	:	1861496846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADALENE K GREENE M.D.

Provider Business Mailing Address
First Line	:	10401 OLD GEORGETOWN RD
Second Line	:	STE 305
City	:	BETHESDA
State	:	MD
Zip	:	20814-1911
Country	:	US
Telephone Number	:	301-530-9490
Fax Number	:	301-530-9493

Provider Business Practice Location Address
First Line	:	10401 OLD GEORGETOWN RD
Second Line	:	STE 305
City	:	BETHESDA
State	:	MD
Zip	:	20814-1911
Country	:	US
Telephone Number	:	301-530-9490
Fax Number	:	301-530-9493

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	01/09/2008

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