Ridenour, Glenn

Ridenour, Glenn is an individual health care provider with primary practice located at 3100 Maccorkle Ave Se Suite 604, Charleston WV 25304-1223. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Ridenour, Glenn can be contacted via phone (304) 345-5421.

Contact Information

Primary practice address
3100 Maccorkle Ave Se Suite 604 Charleston WV 25304-1223
Fax: (304) 345-0951
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 22336 West Virginia
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 22336 West Virginia

Profile Details

NPI number 1598702417
LBN Legal business name Ridenour, Glenn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated May 5th, 2017 - about 7 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 1598702417 NPPES
West Virginia MEDICAID 3810005579

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