Yamagata, Glenn Takeshi
Yamagata, Glenn Takeshi is an sole proprietor health care provider with primary practice located at 1331 N Elm St Ste 200 , Greensboro NC 27401-6304. 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. Yamagata, Glenn Takeshi can be contacted via phone (336) 274-9617.Contact Information
Primary practice address
1331 N Elm St Ste 200
Greensboro NC 27401-6304
Phone: (336) 274-9617
Fax: (336) 482-2177
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 9801565 | North Carolina |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 9801565 | North Carolina |
Profile Details
| NPI number | 1598718066 |
|---|---|
| LBN Legal business name | Yamagata, Glenn Takeshi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2006 |
| Last updated | Mar 10th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598718066 | NPPES |
| North Carolina | Other | 88975 | MEDCOST |
| North Carolina | Other | 300100860 | MEDCOST |
| North Carolina | Other | 1608046 | MEDCOST |
| North Carolina | Other | 32127 | MEDCOST |
| North Carolina | Other | 12189 | MEDCOST |
| North Carolina | MEDICAID | 8912189 | MEDCOST |
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