Provider Demographics
NPI:1144562968
Name:GREENBERG, ERIC JACOB (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JACOB
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5085 W BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2922
Mailing Address - Country:US
Mailing Address - Phone:810-243-5085
Mailing Address - Fax:810-243-5088
Practice Address - Street 1:5085 W BRISTOL RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2922
Practice Address - Country:US
Practice Address - Phone:810-243-5085
Practice Address - Fax:810-243-5088
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301113814207P00000X, 207QA0401X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine