Greenwald, Brent H.

Greenwald, Brent H. is an individual health care provider with primary practice located at 3155 Channing Way Suite B, Idaho Falls ID 83404-7546. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Greenwald, Brent H. can be contacted via phone (208) 535-4800.

Contact Information

Primary practice address
3155 Channing Way Suite B Idaho Falls ID 83404-7546
Phone: (208) 535-4800
Fax: (208) 535-4807
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X M-6947 Idaho

Profile Details

NPI number 1134155666
LBN Legal business name Greenwald, Brent H.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2006
Last updated Jul 13th, 2009 - about 15 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 1134155666 NPPES
Idaho Other 000010001551 BLUE SHIELD
Idaho MEDICAID 002786100 BLUE SHIELD
Idaho Other 82-0529781 BLUE SHIELD
Idaho Other 76836 BLUE SHIELD
Idaho Other 8M987 BLUE SHIELD

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