Provider Demographics
NPI:1467462713
Name:GREENBLUM, DAVID NATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NATHAN
Last Name:GREENBLUM
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 1:10400 CONNECTICUT AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3910
Mailing Address - Country:US
Mailing Address - Phone:202-363-2575
Mailing Address - Fax:
Practice Address - Street 1:10400 CONNECTICUT AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3910
Practice Address - Country:US
Practice Address - Phone:202-363-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00418572084P0800X
MDD00768712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry