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1073723086

NPI Code Detail

MEDICARE: JULIANNE VERNADETTE GREEN MD

MEDICARE: JULIANNE VERNADETTE GREEN MD

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	208000000X	Pediatrics Physician	48755	KY
2	2080P0208X	Pediatric Infectious Diseases Physician	2015-02039	NC
3	2080P0208X	Pediatric Infectious Diseases Physician	48755	KY
4	2080P0208X	Pediatric Infectious Diseases Physician	35.093233	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073723086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANNE VERNADETTE GREEN MD

Provider Business Mailing Address
First Line	:	PO BOX 933432
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44193-0039
Country	:	US
Telephone Number	:	937-641-5072
Fax Number	:	937-641-6129

Provider Business Practice Location Address
First Line	:	1 CHILDRENS PLZ
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45404-1815
Country	:	US
Telephone Number	:	937-641-4000
Fax Number	:	937-641-4500

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	02/09/2026

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Directions to “ JULIANNE VERNADETTE GREEN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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