Healthcare Provider Details

I. General information

NPI: 1235146069
Provider Name (Legal Business Name): MARY A GREENE-MCINTYRE M.D., M.P.H, SSBB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 MONROE STREET RSA TOWER STE 1466
MONTGOMERY AL
36130-3017
US

IV. Provider business mailing address

201 MONROE STREET RSA TOWER STE 1466 P.O. BOX 303017
MONTGOMERY AL
36130-3017
US

V. Phone/Fax

Practice location:
  • Phone: 334-206-5325
  • Fax: 334-206-0354
Mailing address:
  • Phone: 334-206-5325
  • Fax: 334-206-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number12877
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number12877
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: