Healthcare Provider Details

I. General information

NPI: 1831189711
Provider Name (Legal Business Name): WILLIAM H GREENWOOD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 SATELLITE BLVD NW SUITE 100
SUWANEE GA
30024-4624
US

IV. Provider business mailing address

100 GALLERIA PKWY SE SUITE 1100
ATLANTA GA
30339-3179
US

V. Phone/Fax

Practice location:
  • Phone: 678-957-0757
  • Fax: 678-957-9597
Mailing address:
  • Phone: 770-953-6929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number030074
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: