Provider Demographics
NPI:1982693792
Name:GREENE, COLIN M (MD)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:M
Last Name:GREENE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:806 BETHESDA AVE
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-3508
Mailing Address - Country:US
Mailing Address - Phone:910-907-6498
Mailing Address - Fax:910-907-8473
Practice Address - Street 1:2817 REILLY RD
Practice Address - Street 2:WAMC ATTN: DCCS
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-7324
Practice Address - Country:US
Practice Address - Phone:910-907-6498
Practice Address - Fax:910-907-8473
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101038830207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine