Provider Demographics
NPI:1356652937
Name:LONDON, CATHLEEN GREENBERG (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:GREENBERG
Last Name:LONDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 BULLWINKLE DR
Mailing Address - Street 2:
Mailing Address - City:MILBRIDGE
Mailing Address - State:ME
Mailing Address - Zip Code:04658-3763
Mailing Address - Country:US
Mailing Address - Phone:207-847-8020
Mailing Address - Fax:
Practice Address - Street 1:26 BULLWINKLE DR
Practice Address - Street 2:
Practice Address - City:MILBRIDGE
Practice Address - State:ME
Practice Address - Zip Code:04658-3763
Practice Address - Country:US
Practice Address - Phone:207-847-8020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD20645207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAG91513Medicare UPIN
MEG91513Medicare UPIN