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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. MICHAEL MATTHEW GREEN, D.O.

Active

DR. MICHAEL MATTHEW GREEN, D.O. is a Pediatric Rehabilitation Medicine healthcare provider located in SALT LAKE CITY, Utah. NPI 1063665719 is currently active in the NPPES registry. Verify at CMS.

Pediatric Rehabilitation Medicine · SALT LAKE CITY, UT

Registration Details

NPI Number
1063665719
Provider Type
Individual
Gender
Male
NPI Issued
Oct 28, 2008 (17.60829742209 yrs)
Last Updated
Dec 10, 2021
Licenses
BP10031712 (TX)
2011017820 (MO)
8728465-1204 (UT)
8728465-1204 (UT)

Practice Information

Address
81 N MARIO CAPECCHI DR
DEPARTMENT OF PEDIATRICS
SALT LAKE CITY, UT, 841131125
Browse UT providers · Browse ZIP 84113
Phone
8012137737
Fax
8015877539
Primary Specialty
Pediatric Rehabilitation Medicine
2081P0010X
Additional Specialty
Brain Injury Medicine

Other Pediatric Rehabilitation Medicine Providers in SALT LAKE CITY, UT

Name Credential NPI
DR. NANCY A MURPHY MD 1922117977
SHANE CARLSON DANGERFIELD M.D. 1457685919
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.