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General NPI Number Information
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NPI Number | 1326174327
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Entity Type | Organization
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Legal Business Name | STEVEN T. GREENHAW MD PC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 09/30/2010
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Provider Practice Location Address
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Address Line | 2704 N OAK ST BLDG G
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City | VALDOSTA
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State | GA
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Zip | 31602-1767
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Country | US
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Telephone | 229-245-7070
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Fax | 229-245-9005
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Provider Business Mailing Address
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Address Line | PO BOX 3910
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City | VALDOSTA
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State | GA
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Zip | 31604-3910
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Country | US
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Telephone | 229-245-7070
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Fax | 229-245-9005
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN T GREENHAW
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Credential | MD
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Telephone | 229-245-7070
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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 | 035427
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License Number State | GA
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