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NPI Code Detail

MEDICARE: LEVERNE GREEN M.D.

MEDICARE: LEVERNE GREEN 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
1207L00000XAnesthesiology Physician25162CO

General Provider Information

NPI Number : 1962422857
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEVERNE GREEN M.D.
Provider Business Mailing Address
First Line : 3722 S QUEBEC ST
Second Line :
City : DENVER
State : CO
Zip : 80237-1339
Country : US
Telephone Number : 303-740-8133
Fax Number :
Provider Business Practice Location Address
First Line : 3722 S QUEBEC ST
Second Line :
City : DENVER
State : CO
Zip : 80237-1339
Country : US
Telephone Number : 303-740-8133
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2006
Last Update Date : 07/08/2007

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Directions to “ LEVERNE GREEN M.D.” Practice Location

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