Provider Demographics
NPI:1437192762
Name:GREENE, STEPHEN M (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:GREENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3824 NORTHERN PIKE
Mailing Address - Street 2:STE 700
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2141
Mailing Address - Country:US
Mailing Address - Phone:412-457-0060
Mailing Address - Fax:
Practice Address - Street 1:310 RODI RD
Practice Address - Street 2:STE 140
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-3318
Practice Address - Country:US
Practice Address - Phone:412-371-6414
Practice Address - Fax:412-371-9739
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD047091L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
102117OtherUPMC HEALTH PLAN
370010980OtherRAILROAD MEDICARE
084286OtherBLUE SHIELD
4268645OtherAETNA
PA001294998Medicaid
P000829OtherGATEWAY HEALTH PLAN
084286OtherBLUE SHIELD
4268645OtherAETNA
4268645OtherAETNA