Provider Demographics
NPI:1689631640
Name:YEARWOOD, GREIGSTONE MONTGOMERY (MD)
Entity Type:Individual
Prefix:DR
First Name:GREIGSTONE
Middle Name:MONTGOMERY
Last Name:YEARWOOD
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 1:191 SOCIAL ST
Mailing Address - Street 2:SUITE 840
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3240
Mailing Address - Country:US
Mailing Address - Phone:401-762-2535
Mailing Address - Fax:401-762-2858
Practice Address - Street 1:191 SOCIAL ST
Practice Address - Street 2:SUITE 840
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3240
Practice Address - Country:US
Practice Address - Phone:401-762-2535
Practice Address - Fax:401-762-2858
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD07911207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI9020093Medicaid
RIF01420Medicare UPIN
RI9020093Medicaid