Provider Demographics
NPI:1457821027
Name:GREENE, MILTON P C III
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:P C
Last Name:GREENE
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1411
Mailing Address - Country:US
Mailing Address - Phone:330-996-4600
Mailing Address - Fax:330-564-9296
Practice Address - Street 1:611 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-1411
Practice Address - Country:US
Practice Address - Phone:330-996-4600
Practice Address - Fax:330-564-9296
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH175T00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist