Provider Demographics
NPI:1255489530
Name:MICHELE GREENHOUSE MD
Entity Type:Organization
Organization Name:MICHELE GREENHOUSE MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:NYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-783-1181
Mailing Address - Street 1:9625 N MATUS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-4630
Mailing Address - Country:US
Mailing Address - Phone:559-323-9148
Mailing Address - Fax:559-323-0116
Practice Address - Street 1:9625 N MATUS AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-4630
Practice Address - Country:US
Practice Address - Phone:559-323-9148
Practice Address - Fax:559-323-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty