MITRA MARIE GREEN M.D. NPI 1699702761

NPI Information

NPI: 1699702761
Provider Name: MITRA MARIE GREEN, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual
Address:
3421 MEDICAL PARK DR
MONROE, LA
ZIP 71203
Phone: (318) 376-7337
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Mitra Marie Green, M.D. is a pediatrics in Monroe, LA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Mitra Marie Green, M.D. NPI is 1699702761. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3421 MEDICAL PARK DR
MONROE, LA
ZIP 71203-355
Phone: (318) 376-7337

The enumeration date for this NPI number is 6/26/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		020108	LOUISIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1950831	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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