Healthcare Provider Details

I. General information

NPI: 1063428340
Provider Name (Legal Business Name): ROBERT A GREENE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 W COUNTY LINE ROAD
LITTLETON CO
80129
US

IV. Provider business mailing address

271 W COUNTY LINE ROAD
LITTLETON CO
80129
US

V. Phone/Fax

Practice location:
  • Phone: 303-794-0045
  • Fax: 303-347-9052
Mailing address:
  • Phone: 303-794-0045
  • Fax: 303-347-9052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number0055120
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: