Healthcare Provider Details

I. General information

NPI: 1154735264
Provider Name (Legal Business Name): MICHAEL GREENFIELD DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 06/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 OAKLAND ST
HENDERSONVILLE NC
28791-3648
US

IV. Provider business mailing address

8 TOWN SQUARE BLVD #311
ASHEVILLE NC
28803-5044
US

V. Phone/Fax

Practice location:
  • Phone: 828-696-0800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number005445
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: