Black, Glenn Raymond

Black, Glenn Raymond is an sole proprietor health care provider with primary practice located at 103 5Th St Se Ste S, Barberton OH 44203-4256. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Black, Glenn Raymond can be contacted via phone (330) 753-5863.

Contact Information

Primary practice address
103 5Th St Se Ste S Barberton OH 44203-4256
Phone: (330) 753-5863
Fax: (330) 753-9838
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 35.036808 Ohio

Profile Details

NPI number 1700860970
LBN Legal business name Black, Glenn Raymond
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 1st, 2005
Last updated Apr 2nd, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700860970 NPPES
Ohio Other 107535 KAISER
Ohio Other 1786246 KAISER
Ohio Other 341397094026 KAISER
Ohio Other 000000191152 KAISER
Ohio Other 0400075 KAISER
Ohio Other 729783 KAISER
Ohio Other 4205812 KAISER
Ohio MEDICAID 0429549 KAISER
Ohio Other 1263551 KAISER
Ohio Other 59634 KAISER
Ohio Other 791063783 KAISER

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