MEDICARE: MR. ARTHUR J GREENE 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	2085R0202X	Diagnostic Radiology Physician	25MA04604900	NJ
2	2085R0202X	Diagnostic Radiology Physician	4301079044	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G8865226	OTHER	WA	MEDICARE - WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	3105211271	OTHER	MI	BCBS OF MICHIGAN

General Provider Information

NPI Number	:	1508834359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARTHUR J GREENE MD

Provider Business Mailing Address
First Line	:	1101 KINGS HWY N
Second Line	:	SUITE 104
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-1912
Country	:	US
Telephone Number	:	856-482-2900
Fax Number	:	856-482-5127

Provider Business Practice Location Address
First Line	:	1000 S LENOLA RD
Second Line	:	STE 105
City	:	MAPLE SHADE
State	:	NJ
Zip	:	08052-1630
Country	:	US
Telephone Number	:	856-482-2900
Fax Number	:	856-482-5127

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	05/26/2016

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Directions to “ MR. ARTHUR J GREENE MD” Practice Location

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