=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306307285
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN ALEXANDRE GREENBERG MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2019
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 193 MAIN ST
-----------------------------------------------------
City | NORWAY
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04268-5645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-828-2100
-----------------------------------------------------
Fax | 207-743-5026
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 193 MAIN ST
-----------------------------------------------------
City | NORWAY
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04268-5645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-828-2100
-----------------------------------------------------
Fax | 207-743-5026
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | MD29523
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207QS0010X
-----------------------------------------------------
Taxonomy Name | Sports Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number | MD29523
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 2022-02231
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------