Provider Demographics
NPI:1700881091
Name:GREENSEID, DAVID Z (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:Z
Last Name:GREENSEID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:220 HUMPHREY ST
Mailing Address - Street 2:#207
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-1662
Mailing Address - Country:US
Mailing Address - Phone:781-631-1339
Mailing Address - Fax:781-631-1222
Practice Address - Street 1:225 BOSTON ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-3137
Practice Address - Country:US
Practice Address - Phone:781-581-7333
Practice Address - Fax:781-598-2447
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA34204207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2012677Medicaid
MAD14244Medicare ID - Type Unspecified
MA2012677Medicaid