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General NPI Number Information
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NPI Number | 1255460887
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Entity Type | Organization
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Legal Business Name | HAROLD T GREEN JR MD PC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 03/31/2010
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Provider Practice Location Address
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Address Line | 2421 CHAMBERLAYNE AVE
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City | RICHMOND
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State | VA
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Zip | 23222-4205
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Country | US
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Telephone | 804-329-8510
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Fax | 804-329-2160
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Provider Business Mailing Address
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Address Line | 2421 CHAMBERLAYNE AVE
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City | RICHMOND
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State | VA
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Zip | 23222-4205
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Country | US
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Telephone | 804-329-8510
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Fax | 804-329-2160
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. HAROLD T GREEN JR.
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Credential | MD
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Telephone | 804-329-8510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 0101030494
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License Number State | VA
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