Glenn, Mel B

Glenn, Mel B is an individual health care provider with primary practice located at 125 Nashua St Srh, Boston MA 02114-1198. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Glenn, Mel B can be contacted via phone (617) 573-2625.

Contact Information

Primary practice address
125 Nashua St Srh Boston MA 02114-1198
Phone: (617) 573-2625
Fax: (617) 573-2769
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 49226 Massachusetts

Profile Details

NPI number 1821089582
LBN Legal business name Glenn, Mel B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Aug 16th, 2012 - about 12 years ago

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 1821089582 NPPES
Massachusetts MEDICAID 0181749
Massachusetts Other 049226
Massachusetts Other E05923

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