MEDICARE: BRETT I. GREENBERGER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	DO061072	MD

General Provider Information

NPI Number	:	1073591558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT I. GREENBERGER M.D.

Provider Business Mailing Address
First Line	:	5750 PARK HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-3930
Country	:	US
Telephone Number	:	410-843-7415
Fax Number	:	410-500-5958

Provider Business Practice Location Address
First Line	:	5750 PARK HEIGHTS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-3930
Country	:	US
Telephone Number	:	410-843-7415
Fax Number	:	410-500-5958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	10/01/2014

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