Provider Demographics
NPI:1558464370
Name:GREENSTON, MATHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:
Last Name:GREENSTON
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 1:100 MCGREGOR ST
Mailing Address - Street 2:EMERGENCY DEPT
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3730
Mailing Address - Country:US
Mailing Address - Phone:603-663-6472
Mailing Address - Fax:603-926-2853
Practice Address - Street 1:100 MCGREGOR ST
Practice Address - Street 2:CMC - EMERGENCY DEPARTMENT
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3730
Practice Address - Country:US
Practice Address - Phone:603-663-6478
Practice Address - Fax:603-926-2853
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11246207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30206501Medicaid
4129232OtherMVP
MA2130700Medicaid
000000042678OtherBMC HEALTHNET PLAN
AA79987OtherHARVARD PILGRIM
NH01Y003100NH03OtherANTHEM
ME434911199Medicaid
P00384959OtherRAILROAD MEDICARE
P00384959OtherRAILROAD MEDICARE
NH01Y003100NH03OtherANTHEM
AA79987OtherHARVARD PILGRIM