Provider Demographics
NPI:1265546212
Name:GREENBLOTT, DAVID HUGH (DPM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:HUGH
Last Name:GREENBLOTT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 208
Mailing Address - Street 2:
Mailing Address - City:WEST NEWBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01985-0208
Mailing Address - Country:US
Mailing Address - Phone:978-556-9700
Mailing Address - Fax:978-521-8542
Practice Address - Street 1:62 BROWN ST
Practice Address - Street 2:STE 206
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6790
Practice Address - Country:US
Practice Address - Phone:978-556-9700
Practice Address - Fax:617-567-2121
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2036213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA23-7425849OtherUNICARE
MAAA3102OtherHAVARD PILGRIM HEALTH PLA
MA000000007083OtherBMC HEALTH NET
MA2700077OtherUNITED HEALTH CARE
MA98140201OtherNETWORK HEALTH
MA043043013MOtherCIGNA
MA0358509Medicaid
MA1230446OtherFALLON
MA0006166OtherNEIGHBORHOOD HEALTH PLAN
MA2700023OtherEVERCARE
MA480019491OtherRAILROAD MEDIARE
MATUFTSOther002036
MAY70996OtherBCBS
MAAA3102OtherHAVARD PILGRIM HEALTH PLA
MA2700077OtherUNITED HEALTH CARE
MATUFTSOther002036