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NPI Code Detail

MEDICARE: HAROLD T GREEN JR. M.D.

MEDICARE: HAROLD T GREEN JR. 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
1207R00000XInternal Medicine Physician0101030494VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4110054353OTHERVARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
146320OTHERVAAETNA
2813839OTHERVAMAMSI
3V6046029OTHERVAVIRGINIA COORDINATED CARE
5C03017OTHERVAGROUP PTAN
646320OTHERVAUNITED HEALTHCARE
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
844128OTHERVAOPTIMA HEALTH
944128OTHERVASENTARA
1057991OTHERVASOUTHERN HEALTH
11006046029OTHERVAVIRGINIA PREMIER
12094290OTHERVAANTHEM BC/BS
1330291OTHERVACARENET
14C06695OTHERVAGROUP PTAN

General Provider Information

NPI Number : 1427169044
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAROLD T GREEN JR. M.D.
Provider Business Mailing Address
First Line : 2421 CHAMBERLAYNE AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23222-4205
Country : US
Telephone Number : 804-321-4513
Fax Number : 804-329-2160
Provider Business Practice Location Address
First Line : 2421 CHAMBERLAYNE AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23222-4205
Country : US
Telephone Number : 804-321-4513
Fax Number : 804-329-2160
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 12/06/2010

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