Graves, Glenn E.

Graves, Glenn E. is an individual health care provider with primary practice located at 4600 W Loomis Rd Ste 310 , Greenfield WI 53220-4858. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Glaucoma Specialist. Allopathic & Osteopathic Physicians / Glaucoma Specialist is his primary health care specialty. Graves, Glenn E. can be contacted via phone (414) 281-0963.

Contact Information

Primary practice address
4600 W Loomis Rd Ste 310 Greenfield WI 53220-4858
Phone: (414) 281-0963
Fax: (414) 281-0959
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 27890-020 Wisconsin
Allopathic & Osteopathic Physicians / Glaucoma Specialist 207WX0009X 27890-020 Wisconsin

Profile Details

NPI number 1780671677
LBN Legal business name Graves, Glenn E.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Apr 23rd, 2024 - about 7 months 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 1780671677 NPPES
Wisconsin Other 180020621 RR MEDICARE
Wisconsin Other 391484998011 RR MEDICARE
Wisconsin Other 391484998C RR MEDICARE
Wisconsin Other 0800065 RR MEDICARE
Wisconsin Other 391484998 RR MEDICARE
Wisconsin MEDICAID 31485900 RR MEDICARE

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