Provider Demographics
NPI:1205843315
Name:GREELEY, ELIZABETH T (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:T
Last Name:GREELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:J
Other - Last Name:TERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:201 DEFENSE HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-8943
Mailing Address - Country:US
Mailing Address - Phone:443-481-3354
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:820 BESTGATE RD
Practice Address - Street 2:SUITES 2C & 2D
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3404
Practice Address - Country:US
Practice Address - Phone:410-224-4442
Practice Address - Fax:410-224-8898
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223584207V00000X
MDD0066839207V00000X, 207VC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VC0200XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA93335OtherFALLON
MA2103796Medicaid
MDK4800007OtherCAREFIRST BCBS
MD416933600Medicaid
MA460284OtherTUFTS
MA1662090OtherCIGNA
MAAA35636OtherHPHC
MA000000030737OtherBMC HEALTHNET
MAJ28729OtherMABC
412826OtherRI BLUE CHIP
MD547428ZDWSMedicare PIN
MA000000030737OtherBMC HEALTHNET
MA93335OtherFALLON
MAI37148Medicare UPIN