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Individual
DR. JOHN ELLIS GLANCY III
Active
Individual
DR. JOHN ELLIS GLANCY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
D0025345
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0696
BLUECROSS/BLUE SHIELD DC
DC
05
—
373631800
—
MD
Enumeration date
06/16/2005
Last updated
01/13/2010
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