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General NPI Number Information
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NPI Number | 1215290812
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Entity Type | Individual
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Provider Name | DAVID CHRISTOPHER GREEN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 06/19/2012
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Provider Practice Location Address
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Address Line | 4720 CHERRY HILL RD
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City | COLLEGE PARK
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State | MD
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Zip | 20740-1330
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Country | US
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Telephone | 301-345-7738
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Fax | 301-345-6118
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Provider Business Mailing Address
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Address Line | 5029 37TH AVE
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City | HYATTSVILLE
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State | MD
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Zip | 20782-3911
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Country | US
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Telephone | 301-927-0829
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 19509
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License Number State | MD
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