Michael D Green, PA-C

NPI #1699898882 in Sophia, West Virginia

Provider Information

NPI Number: 1699898882
Entity Type: Individual
Name: Michael D Green, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Apr 10, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 410 WEST MAIN STREET
City: Sophia
State: West Virginia
ZIP Code: 25921
Phone: (304) 683-4304

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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