Healthcare Provider Details

I. General information

NPI: 1306377387
Provider Name (Legal Business Name): KATHERINE WHEAT GREER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE GREER MD

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40100 HIGHWAY 27
DAVENPORT FL
33837-5906
US

IV. Provider business mailing address

40100 HIGHWAY 27
DAVENPORT FL
33837-5906
US

V. Phone/Fax

Practice location:
  • Phone: 407-975-0412
  • Fax:
Mailing address:
  • Phone: 407-975-0412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number322126
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME148636
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: