Provider Demographics
NPI:1356343529
Name:GREENFIELD, MARK ALAN (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALAN
Last Name:GREENFIELD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5000 W 95TH ST
Mailing Address - Street 2:STE 310
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66207-3354
Mailing Address - Country:US
Mailing Address - Phone:913-341-5533
Mailing Address - Fax:913-901-0380
Practice Address - Street 1:11413 ASH ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1837
Practice Address - Country:US
Practice Address - Phone:913-663-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2018-07-03
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Provider Licenses
StateLicense IDTaxonomies
KS0424945207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D16942Medicare UPIN