Provider Demographics
NPI:1871523340
Name:GREER, DOUGLAS FIEDLER (MD, PC)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:FIEDLER
Last Name:GREER
Suffix:
Gender:M
Credentials:MD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 NEW MEXICO AVE NW
Mailing Address - Street 2:#214
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3622
Mailing Address - Country:US
Mailing Address - Phone:202-244-5422
Mailing Address - Fax:202-244-2118
Practice Address - Street 1:3301 NEW MEXICO AVE NW
Practice Address - Street 2:#214
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3622
Practice Address - Country:US
Practice Address - Phone:202-244-5422
Practice Address - Fax:202-244-2118
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC6299174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
408631Medicare ID - Type Unspecified
C62531Medicare UPIN