Hidden, Glen Allen

Hidden, Glen Allen is an individual health care provider with primary practice located at 50 E Hospital St Suite 4, Manning SC 29102-3149. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hidden, Glen Allen can be contacted via phone (803) 435-5250.

Contact Information

Primary practice address
50 E Hospital St Suite 4 Manning SC 29102-3149
Phone: (803) 435-5250
Fax: (803) 435-5255
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 043063 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22420 South Carolina

Profile Details

NPI number 1063433050
LBN Legal business name Hidden, Glen Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 22nd, 2006
Last updated Oct 17th, 2010 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063433050 NPPES
Georgia MEDICAID 872533996A

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