Provider Demographics
NPI:1043270911
Name:GREENE, FRANK J (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:J
Last Name:GREENE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10 W SQUARE LAKE RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0465
Mailing Address - Country:US
Mailing Address - Phone:248-858-2238
Mailing Address - Fax:248-858-2310
Practice Address - Street 1:10 W SQUARE LAKE RD
Practice Address - Street 2:SUITE 222
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0465
Practice Address - Country:US
Practice Address - Phone:248-858-2238
Practice Address - Fax:248-858-2310
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2012-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010274442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1062124Medicaid
MI06334973261Medicare ID - Type Unspecified
MI1062124Medicaid