Basic Information
| Provider Information | |||||||||
| NPI: | 1245271220 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GREENBERG | ||||||||
| FirstName: | CAPRICE | ||||||||
| MiddleName: | CHRISTIAN | ||||||||
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| Credential: | MD MPH | ||||||||
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| OtherLastName: | CHRISTIAN | ||||||||
| OtherFirstName: | CAPRICE | ||||||||
| OtherMiddleName: | K | ||||||||
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| OtherCredential: | MD MPH | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1120 15TH ST | ||||||||
| Address2: | STE BI1056 | ||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309120004 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 MANNING DR | ||||||||
| Address2: | |||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275144220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849741000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 10/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 88067 | GA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 2022-02132 | NC | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.