Provider Demographics
NPI:1093779431
Name:GREENBERG, MARC F (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:F
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3225 CUMBERLAND BLVD SE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6407
Mailing Address - Country:US
Mailing Address - Phone:404-351-2220
Mailing Address - Fax:404-352-5392
Practice Address - Street 1:355 TOWER RD NE STE 102
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-9410
Practice Address - Country:US
Practice Address - Phone:770-422-4055
Practice Address - Fax:770-528-6977
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA038241207W00000X, 207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA18DBCVDOtherMEDICARE
GA000608187AMedicaid
GA180033113Medicare PIN
GA18DBCVDOtherMEDICARE
GA000608187AMedicaid