Provider Demographics
NPI:1093768459
Name:GREENWELL, STEVEN ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ARTHUR
Last Name:GREENWELL
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 1:8 DIANA RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528
Mailing Address - Country:US
Mailing Address - Phone:845-834-3475
Mailing Address - Fax:845-838-5274
Practice Address - Street 1:ROUTE 9D
Practice Address - Street 2:
Practice Address - City:CASTLE POINT
Practice Address - State:NY
Practice Address - Zip Code:12511
Practice Address - Country:US
Practice Address - Phone:845-831-2000
Practice Address - Fax:845-838-5274
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042-0010018207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine