Healthcare Provider Details

I. General information

NPI: 1487196366
Provider Name (Legal Business Name): ROBERT G GREENFIELD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8121 GEORGIA AVE
SILVER SPRING MD
20910-4933
US

IV. Provider business mailing address

605 SHERBROOK DR
SILVER SPRING MD
20904-2828
US

V. Phone/Fax

Practice location:
  • Phone: 301-622-0112
  • Fax:
Mailing address:
  • Phone: 301-675-6260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberDOO36948
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: