Provider Demographics
NPI:1366992737
Name:GREENWALD, JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:GREENWALD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1034 S BRENTWOOD BLVD
Mailing Address - Street 2:SUITE 1250
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1223
Mailing Address - Country:US
Mailing Address - Phone:314-367-0777
Mailing Address - Fax:314-367-5982
Practice Address - Street 1:33 W 46TH ST
Practice Address - Street 2:SUITE 4W
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4103
Practice Address - Country:US
Practice Address - Phone:646-722-6214
Practice Address - Fax:646-722-6214
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY255085-1207R00000X
MOR8E94207R00000X
IL036.127243207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine