Green, Eric R

Green, Eric R is an individual health care provider with primary practice located at 926 S Washington Ave , Holland MI 49423-7725. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Green, Eric R can be contacted via phone (616) 393-0166.

Contact Information

Primary practice address
926 S Washington Ave Holland MI 49423-7725
Phone: (616) 393-0166
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 4301080025 Michigan
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301080025 Michigan

Profile Details

NPI number 1194798777
LBN Legal business name Green, Eric R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194798777 NPPES
Michigan Other 4301080025 PHYSICIAN LICENSE
Michigan MEDICAID 4409089 TYPE 10 PHYSICIAN LICENSE
Michigan Other 5315010080 PHYSICIAN LICENSE

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