Green, Glen A.

Green, Glen A. is an individual health care provider with primary practice located at 601 Childrens Ln , Norfolk VA 23507-1910. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is his primary health care specialty. Green, Glen A. can be contacted via phone (757) 668-7456.

Contact Information

Primary practice address
601 Childrens Ln Norfolk VA 23507-1910
Phone: (757) 668-7456
Fax: (757) 668-9255
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 0101039300 Virginia
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101039300 Virginia
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 0101039300 Virginia

Profile Details

NPI number 1477505907
LBN Legal business name Green, Glen A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Dec 9th, 2009 - about 15 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1477505907 NPPES
Delaware MEDICAID 0000931601
Delaware MEDICAID 006722164
Delaware MEDICAID 119981100
Delaware MEDICAID 1802339000
Delaware MEDICAID 0018694320001
Delaware MEDICAID 890677B

Popular Providers