Provider Demographics
NPI:1962491456
Name:GREENBERG, JAMES ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ADAM
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1153 CENTRE ST
Mailing Address - Street 2:SUITE 36
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-3446
Mailing Address - Country:US
Mailing Address - Phone:617-983-7003
Mailing Address - Fax:617-983-7499
Practice Address - Street 1:1153 CENTRE ST
Practice Address - Street 2:SUITE 36
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-3446
Practice Address - Country:US
Practice Address - Phone:617-983-7003
Practice Address - Fax:617-983-7499
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2012-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA74712207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3121305Medicaid
MAJ12597OtherBCBS
MA724874OtherTUFTS HEALTH PLAN
F29193Medicare UPIN
MA724874OtherTUFTS HEALTH PLAN