Provider Demographics
NPI:1750316204
Name:GREENE, CHERICE L (MD)
Entity Type:Individual
Prefix:
First Name:CHERICE
Middle Name:L
Last Name:GREENE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1416 GOLDEN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-6924
Mailing Address - Country:US
Mailing Address - Phone:256-831-4554
Mailing Address - Fax:256-831-4979
Practice Address - Street 1:1416 GOLDEN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-6924
Practice Address - Country:US
Practice Address - Phone:256-831-4554
Practice Address - Fax:256-831-4979
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301086486207Q00000X
AL30624207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL132055Medicaid