MEDICARE: STEPHEN GREER DO INC

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	2086S0129X	Vascular Surgery Physician	34-00-3010	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

General Provider Information

NPI Number	:	1558361329
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN GREER DO INC

Provider Business Mailing Address
First Line	:	131 N LUDLOW ST
Second Line	:	SUITE 1125
City	:	DAYTON
State	:	OH
Zip	:	45402-1116
Country	:	US
Telephone Number	:	937-223-2911
Fax Number	:	937-461-5102

Provider Business Practice Location Address
First Line	:	131 N LUDLOW ST
Second Line	:	SUITE 1125
City	:	DAYTON
State	:	OH
Zip	:	45402-1116
Country	:	US
Telephone Number	:	937-223-2911
Fax Number	:	937-461-5102

Authorized Official
Title or Position	:	PRESIDENT/SURGEON
Name	:	STEPHEN GREER
Credential	:	DO
Telephone Number	:	937-223-2911

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	08/22/2020

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Directions to “STEPHEN GREER DO INC ” Practice Location

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