Provider Demographics
NPI:1235146069
Name:GREENE-MCINTYRE, MARY A (MD, MPH, SSBB)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:A
Last Name:GREENE-MCINTYRE
Suffix:
Gender:F
Credentials:MD, MPH, SSBB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MONROE STREET RSA TOWER STE 1466
Mailing Address - Street 2:P.O. BOX 303017
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36130-3017
Mailing Address - Country:US
Mailing Address - Phone:334-206-5325
Mailing Address - Fax:334-206-0354
Practice Address - Street 1:201 MONROE STREET RSA TOWER STE 1466
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36130-3017
Practice Address - Country:US
Practice Address - Phone:334-206-5325
Practice Address - Fax:334-206-0354
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL128772083P0901X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL12377OtherLICENSE NUMBER
AL12377OtherLICENSE NUMBER