Provider Demographics
NPI:1982329926
Name:GREENSPRING PERSONAL MEDICINE, LLC
Entity Type:Organization
Organization Name:GREENSPRING PERSONAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGAZINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-718-4840
Mailing Address - Street 1:2328 W JOPPA RD STE 310
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4685
Mailing Address - Country:US
Mailing Address - Phone:410-616-2804
Mailing Address - Fax:410-583-7147
Practice Address - Street 1:2328 W JOPPA RD STE 310
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4685
Practice Address - Country:US
Practice Address - Phone:410-616-2804
Practice Address - Fax:410-583-7147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-11
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty