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NPI Code Detail

MEDICARE: JAMES CHAD GREENE MD

MEDICARE: JAMES CHAD 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
1208D00000XGeneral Practice Physician0101244091VA
22085R0202XDiagnostic Radiology PhysicianA140115CA

General Provider Information

NPI Number : 1619137825
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES CHAD GREENE MD
Provider Business Mailing Address
First Line : 1800 AIRPARK DR
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-1412
Country : US
Telephone Number : 865-850-6853
Fax Number :
Provider Business Practice Location Address
First Line : 1800 AIRPARK DR
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-1412
Country : US
Telephone Number : 865-850-6853
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2008
Last Update Date : 08/12/2021

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