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General NPI Number Information
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NPI Number | 1609142041
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Entity Type | Individual
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Provider Name | JEREMY ADAM GREENBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 07/05/2018
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Provider Practice Location Address
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Address Line | 979 E 3RD ST STE C735
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City | CHATTANOOGA
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State | TN
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Zip | 37403
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Country | US
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Telephone | 423-778-9101
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Fax | 423-778-9190
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Provider Business Mailing Address
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Address Line | 979 E 3RD ST STE C735
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City | CHATTANOOGA
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State | TN
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Zip | 37403-3310
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Country | US
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Telephone | 423-778-9101
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Fax | 423-778-9190
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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 | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 51072
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License Number State | TN
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