Nudelman, Glenn L
Nudelman, Glenn L is an individual health care provider with primary practice located at 2191 Chip Dr , Lake Havasu City AZ 86406-7645. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Nudelman, Glenn L can be contacted via phone (928) 486-4387.Contact Information
Primary practice address
2191 Chip Dr
Lake Havasu City AZ 86406-7645
Phone: (928) 486-4387
Fax: (928) 302-3515
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 14122 | Arizona |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | AN14122 | Arizona |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 14122 | Arizona |
Profile Details
| NPI number | 1346242427 |
|---|---|
| LBN Legal business name | Nudelman, Glenn L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Jul 29th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346242427 | NPPES |
| Arizona | Other | 110044210 | RAILROAD MEDICARE |
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