Provider Demographics
NPI:1083833677
Name:GREENBERG, ARTHUR PAUL (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:PAUL
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 NW 82ND CT
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-3763
Mailing Address - Country:US
Mailing Address - Phone:573-819-4992
Mailing Address - Fax:
Practice Address - Street 1:2004 NW 82ND CT
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-3763
Practice Address - Country:US
Practice Address - Phone:573-819-4992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002023835208D00000X
KS29721208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOD61540Medicare UPIN