Healthcare Provider Details

I. General information

NPI: 1841465267
Provider Name (Legal Business Name): ARI D GREENBERG PAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2008
Last Update Date: 04/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 12TH AVE N SUITE 2E
BILLINGS MT
59101-7506
US

IV. Provider business mailing address

PO BOX 1196
BILLINGS MT
59103-1196
US

V. Phone/Fax

Practice location:
  • Phone: 406-237-5862
  • Fax:
Mailing address:
  • Phone: 406-237-5862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number313
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: