Green, Jonathan S

Green, Jonathan S is an individual health care provider with primary practice located at 4420 Lake Boone Trl , Raleigh NC 27607. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospitalist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Green, Jonathan S can be contacted via phone (919) 784-7093.

Contact Information

Primary practice address
4420 Lake Boone Trl Raleigh NC 27607
Phone: (919) 784-7093
Fax: (919) 784-7395
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 200100242 North Carolina
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 200100242 North Carolina

Profile Details

NPI number 1750368148
LBN Legal business name Green, Jonathan S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2005
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 1750368148 NPPES
North Carolina MEDICAID 89128U7
North Carolina Other 128U7

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