Provider Demographics
NPI:1629457775
Name:GREEN-MULDROW, BARBARA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:LEE
Last Name:GREEN-MULDROW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:110 GRAN DE CT
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-4039
Mailing Address - Country:US
Mailing Address - Phone:404-993-5812
Mailing Address - Fax:770-994-1219
Practice Address - Street 1:110 GRAN DE CT
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-4039
Practice Address - Country:US
Practice Address - Phone:404-993-5812
Practice Address - Fax:770-994-1219
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA031927207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine