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General NPI Number Information
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NPI Number | 1720009566
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Entity Type | Individual
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Provider Name | ADRIENNE RUTH GREENLAW MD
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Gender | Female
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | 87 SPRING ST UNIT 101
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City | LACONIA
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State | NH
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Zip | 03246-3135
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Country | US
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Telephone | 603-524-3211
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Fax | 603-524-0089
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Provider Business Mailing Address
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Address Line | 87 SPRING ST UNIT 101
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City | LACONIA
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State | NH
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Zip | 03246-3135
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Country | US
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Telephone | 603-524-3211
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Fax | 603-524-0089
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 10025
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License Number State | NH
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