Provider Demographics
NPI:1861496846
Name:GREENE, MADALENE K (MD)
Entity Type:Individual
Prefix:DR
First Name:MADALENE
Middle Name:K
Last Name:GREENE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10401 OLD GEORGETOWN RD
Mailing Address - Street 2:STE 305
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1911
Mailing Address - Country:US
Mailing Address - Phone:301-530-9490
Mailing Address - Fax:301-530-9493
Practice Address - Street 1:10401 OLD GEORGETOWN RD
Practice Address - Street 2:STE 305
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1911
Practice Address - Country:US
Practice Address - Phone:301-530-9490
Practice Address - Fax:301-530-9493
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2008-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD38031207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF14104Medicare UPIN
MDG02693P01Medicare PIN