Provider Demographics
NPI:1134272149
Name:GREENBERG, LAWRENCE HOWARD (MD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:HOWARD
Last Name:GREENBERG
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 1:2000 REGENCY PKWY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-8506
Mailing Address - Country:US
Mailing Address - Phone:919-469-9888
Mailing Address - Fax:919-469-8294
Practice Address - Street 1:2000 REGENCY PKWY
Practice Address - Street 2:SUITE 204
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8506
Practice Address - Country:US
Practice Address - Phone:919-469-9888
Practice Address - Fax:919-469-8294
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2011-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC387192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E46892Medicare UPIN
2149620Medicare ID - Type Unspecified