Healthcare Provider Details

I. General information

NPI: 1407908403
Provider Name (Legal Business Name): SCOTT GREENFIELD MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8110 MIDLOTHIAN TPKE
RICHMOND VA
23235-5116
US

IV. Provider business mailing address

5000 COX RD STE 100
GLEN ALLEN VA
23060-9263
US

V. Phone/Fax

Practice location:
  • Phone: 804-320-8160
  • Fax: 804-320-2189
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number0101035490
License Number StateVA

VIII. Authorized Official

Name: WARREN BRIDGERS
Title or Position: DIR OF PHARMACY
Credential:
Phone: 804-968-5700