Provider Demographics
NPI:1851707616
Name:GREENBAUM, SAUL M (MD)
Entity Type:Individual
Prefix:
First Name:SAUL
Middle Name:M
Last Name:GREENBAUM
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:PO BOX 381662
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38183-1662
Mailing Address - Country:US
Mailing Address - Phone:901-512-8258
Mailing Address - Fax:901-252-0055
Practice Address - Street 1:995 S YATES RD STE 3
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-0882
Practice Address - Country:US
Practice Address - Phone:901-512-8258
Practice Address - Fax:901-252-0055
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN60765207RA0201X
OH57.024300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology