Healthcare Provider Details

I. General information

NPI: 1376877142
Provider Name (Legal Business Name): FRANK J. GREENE M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 09/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 W SQUARE LAKE RD SUITE 222
BLOOMFIELD HILLS MI
48302-0465
US

IV. Provider business mailing address

10 W SQUARE LAKE RD SUITE 222
BLOOMFIELD HILLS MI
48302-0465
US

V. Phone/Fax

Practice location:
  • Phone: 248-858-2238
  • Fax:
Mailing address:
  • Phone: 248-858-2238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number4301027444
License Number StateMI

VIII. Authorized Official

Name: ALAINE LOWE
Title or Position: OFFICE MANAGER
Credential:
Phone: 248-858-2238