Provider Demographics
NPI:1376877142
Name:FRANK J. GREENE M.D., P.C.
Entity type:Organization
Organization Name:FRANK J. GREENE M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-858-2238
Mailing Address - Street 1:10 W SQUARE LAKE RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0465
Mailing Address - Country:US
Mailing Address - Phone:248-858-2238
Mailing Address - Fax:
Practice Address - Street 1:10 W SQUARE LAKE RD
Practice Address - Street 2:SUITE 222
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0465
Practice Address - Country:US
Practice Address - Phone:248-858-2238
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301027444261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1062124Medicaid
MI1062124Medicaid
B45544Medicare UPIN