Green, Mark

Green, Mark is an individual health care provider with primary practice located at 90 Concord Ave , Belmont MA 02478-4046. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Addiction Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Green, Mark can be contacted via phone (857) 598-2808.

Contact Information

Primary practice address
90 Concord Ave Belmont MA 02478-4046
Phone: (857) 598-2808
Fax: (857) 598-2864
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X 222713 Massachusetts
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X 222713 Massachusetts
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 222713 Massachusetts

Profile Details

NPI number 1407075294
LBN Legal business name Green, Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2007
Last updated Jul 15th, 2015 - about 9 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 1407075294 NPPES
Colorado MEDICAID 41035810
Colorado Other 021927

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