Provider Demographics
NPI:1386640027
Name:GREER, JEFFREY N (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:N
Last Name:GREER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 WATERCOVE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-3982
Mailing Address - Country:US
Mailing Address - Phone:804-744-0200
Mailing Address - Fax:804-744-8417
Practice Address - Street 1:3000 WATERCOVE RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-3982
Practice Address - Country:US
Practice Address - Phone:804-774-0200
Practice Address - Fax:804-744-8417
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101234412207Q00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA465723OtherANTHEM
VA1386640027Medicaid
VA1386640027Medicaid
VAMC11089Medicare PIN
VAH84802Medicare UPIN
VA001741T37Medicare ID - Type Unspecified
VAMC11088Medicare PIN
VAP00686169Medicare PIN