Provider Demographics
NPI:1447569116
Name:GREBERMAN, MELVYN (MD)
Entity Type:Individual
Prefix:DR
First Name:MELVYN
Middle Name:
Last Name:GREBERMAN
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 1:1101 DALE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1607
Mailing Address - Country:US
Mailing Address - Phone:301-589-8062
Mailing Address - Fax:661-885-6739
Practice Address - Street 1:1101 DALE DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1607
Practice Address - Country:US
Practice Address - Phone:301-589-8062
Practice Address - Fax:661-885-6739
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00064782083P0901X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology