Provider Demographics
NPI:1861655318
Name:GREENE, WILLIAM R (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:GREENE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8803 KINGS RD
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4723
Mailing Address - Country:US
Mailing Address - Phone:843-997-6915
Mailing Address - Fax:843-449-7266
Practice Address - Street 1:8803 KINGS RD
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4723
Practice Address - Country:US
Practice Address - Phone:843-997-6915
Practice Address - Fax:843-449-7266
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-04
Last Update Date:2008-07-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC8737208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology