| Doctor Name: | MR. MICHAEL V. GREENWELL |
| NPI Number: | 1104821735 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 207RG0100X |
| Business Practice Address: | 3950 Kresge Way Ste 207 Louisville, KY - 402074637 |
| Business Phone Number: | 5028930220 |
| Business Fax Number: | 5028930563 |
| Mailing Address: | Po Box 950296, LOUISVILLE |
| State: | KY |
| Postal Code: | 402950296 |
| Phone Number: | 5028930220 |
| Fax Number: | 5028930563 |
| NPI Enumeration Date: | 06/20/2005 |
| NPI Last Update Date: | 08/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 207RG0100X |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KY |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |