Kerwin, Glenn A

Kerwin, Glenn A is an individual health care provider with primary practice located at 790 Church St Ne Ste 400, Marietta GA 30060-7282. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Kerwin, Glenn A can be contacted via phone (770) 952-8899.

Contact Information

Primary practice address
790 Church St Ne Ste 400 Marietta GA 30060-7282
Phone: (770) 952-8899
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 040704 Georgia
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 040704 Georgia

Profile Details

NPI number 1265408454
LBN Legal business name Kerwin, Glenn A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Nov 20th, 2023 - 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 1265408454 NPPES
Georgia MEDICAID 000859889

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