Provider Demographics
NPI:1245542224
Name:GREENOUGH, MARGARET B (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:B
Last Name:GREENOUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4251 S HIGUERA ST STE 701
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7742
Mailing Address - Country:US
Mailing Address - Phone:805-505-9899
Mailing Address - Fax:805-439-0138
Practice Address - Street 1:4251 S HIGUERA ST STE 701
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7742
Practice Address - Country:US
Practice Address - Phone:805-505-9899
Practice Address - Fax:805-439-0138
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA128317207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB230905OtherMEDICARE ID