Provider Demographics
NPI:1518447234
Name:GREENBERG, DAVID PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:GREENBERG
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 1:1 DISCOVERY DR BLDG 60
Mailing Address - Street 2:
Mailing Address - City:SWIFTWATER
Mailing Address - State:PA
Mailing Address - Zip Code:18370-9100
Mailing Address - Country:US
Mailing Address - Phone:570-957-3289
Mailing Address - Fax:
Practice Address - Street 1:1 DISCOVERY DR BLDG 60
Practice Address - Street 2:
Practice Address - City:SWIFTWATER
Practice Address - State:PA
Practice Address - Zip Code:18370-9100
Practice Address - Country:US
Practice Address - Phone:570-957-3289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD059680L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics