Healthcare Provider Details

I. General information

NPI: 1255310272
Provider Name (Legal Business Name): JEFFREY T GREENWOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EAST CARROLL STREET
SALISBURY MD
21801
US

IV. Provider business mailing address

PO BOX 3012
WILMINGTON DE
19804
US

V. Phone/Fax

Practice location:
  • Phone: 410-543-7100
  • Fax: 410-546-6350
Mailing address:
  • Phone: 302-224-5678
  • Fax: 302-224-2848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0048130
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: