Provider Demographics
NPI:1649441676
Name:CHARLES H. GREENBERG, M.D.P.C
Entity type:Organization
Organization Name:CHARLES H. GREENBERG, M.D.P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:HYMAN
Authorized Official - Last Name:GREENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-649-2820
Mailing Address - Street 1:3001 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3101
Mailing Address - Country:US
Mailing Address - Phone:248-649-2821
Mailing Address - Fax:248-649-1444
Practice Address - Street 1:3001 W BIG BEAVER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3101
Practice Address - Country:US
Practice Address - Phone:248-649-2821
Practice Address - Fax:248-649-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
4294940001Medicare NSC