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General NPI Number Information
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NPI Number | 1073562088
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Entity Type | Individual
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Provider Name | TIMOTHY J GREENAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 14915 BROSCHART ROAD SUITE 102
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City | ROCKVILLE
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State | MD
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Zip | 20850
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Country | US
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Telephone | 301-251-7897
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Fax | 301-251-7898
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Provider Business Mailing Address
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Address Line | 14915 BROSCHART ROAD SUITE 102
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City | ROCKVILLE
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State | MD
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Zip | 20850
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Country | US
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Telephone | 301-251-7897
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD044122E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0041613
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 205142
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | D0041613
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License Number State | MD
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