Basic Information
| Provider Information | |||||||||
| NPI: | 1598711863 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GREENFIELD | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9825 KENWOOD RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452426251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132215500 | ||||||||
| FaxNumber: | 5132211962 | ||||||||
| Practice Location | |||||||||
| Address1: | 8250 KENWOOD CROSSING WAY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452363668 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132215500 | ||||||||
| FaxNumber: | 5132211962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 031538 | OH | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0289790 | 05 | OH | MEDICAID |