Provider Demographics
NPI:1952074023
Name:GREENE, CALMETA DULCENNA
Entity Type:Individual
Prefix:
First Name:CALMETA
Middle Name:DULCENNA
Last Name:GREENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 BEGONIA DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4266
Mailing Address - Country:US
Mailing Address - Phone:301-518-5894
Mailing Address - Fax:
Practice Address - Street 1:4300 BEGONIA DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4266
Practice Address - Country:US
Practice Address - Phone:301-518-5894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000000OtherN/A