Jeffrey E. Green
Clinic/Center, Health Services in Potomac, MD. Organization (NPI-2).
NPI number1083000939
StatusActive
Last updated in NPPESApr 7, 2015
Details
- NPI
- 1083000939
- Entity type
- Organization (NPI-2)
- Legal business name
- Jeffrey E. Green
- Organization subpart
- No
- Enumeration date
- Apr 7, 2015
- Last updated
- Apr 7, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QH0100X | Clinic/Center, Health Services | D0031283 | MD | Yes |
Practice location
10600 Tanager LnPotomac, MD 20854-6316
Phone 301-332-0467
Mailing address
10600 Tanager LnPotomac, MD 20854-6316
Phone 301-332-0467
Authorized official
Jeffrey Green
Provider
3013320467
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