Healthcare Provider Details

I. General information

NPI: 1093433120
Provider Name (Legal Business Name): BRITTANY DALIA GREENE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2022
Last Update Date: 04/25/2024
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ DIV SURG HPB
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

PO BOX 60352
SAINT LOUIS MO
63160-0352
US

V. Phone/Fax

Practice location:
  • Phone: 314-747-0410
  • Fax: 877-991-8954
Mailing address:
  • Phone: 314-747-0410
  • Fax: 877-991-8954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2022022825
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: