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General NPI Number Information
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NPI Number | 1508835372
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Entity Type | Individual
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Provider Name | DANIEL GREEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15709 YEOHO RD
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City | SPARKS
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State | MD
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Zip | 21152-9620
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Country | US
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Telephone | 410-409-2186
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Fax |
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Provider Business Mailing Address
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Address Line | 25 HOOKS LN SUITE 212
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City | BALTIMORE
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State | MD
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Zip | 21208-1617
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Country | US
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Telephone | 410-653-6500
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | D0039385
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License Number State | MD
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