Glen, Brian Joseph

Glen, Brian Joseph is an individual health care provider with primary practice located at 5301 Veterans Memorial Pkwy Ste 104, Saint Peters MO 63376-2298. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Glen, Brian Joseph can be contacted via phone (636) 939-3362.

Contact Information

Primary practice address
5301 Veterans Memorial Pkwy Ste 104 Saint Peters MO 63376-2298
Phone: (636) 939-3362
Fax: (636) 939-3687
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2022026389 Missouri

Profile Details

NPI number 1043779044
LBN Legal business name Glen, Brian Joseph
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 19th, 2019
Last updated May 9th, 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 1043779044 NPPES
Missouri MEDICAID 200070414

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