Provider Demographics
NPI:1477665867
Name:GREENE, DENISE E (MD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:E
Last Name:GREENE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2669 SCENIC DR
Mailing Address - Street 2:GERALD CHAMPION REGIONAL MEDICAL CENTER
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-8700
Mailing Address - Country:US
Mailing Address - Phone:575-446-5300
Mailing Address - Fax:575-446-5304
Practice Address - Street 1:2669 SCENIC DR
Practice Address - Street 2:GERALD CHAMPION REGIONAL MEDICAL CENTER
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-8700
Practice Address - Country:US
Practice Address - Phone:575-446-5300
Practice Address - Fax:575-446-5304
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-04-27
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Provider Licenses
StateLicense IDTaxonomies
CAA705692084P0800X, 207Q00000X, 207QA0401X
NMMD2010-08042084P0805X, 207QA0401X, 207Q00000X
AZ460342084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH69577Medicare UPIN