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Individual
MICHAEL G GLENN
Active
Individual
MICHAEL G GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD00023724
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039572
LABOR & INDUSTRY
WA
01
—
004104300
IDAHO MEDICAID
WA
01
—
040008993
RAILROAD MEDICARE
WA
05
—
8105280
—
WA
01
—
GL3329
BLUE SHIELD
WA
01
—
MD7224
ALASKA MEDICAID
WA
01
—
US0862705
AETNA/USHC SPECIALIST
WA
Enumeration date
07/25/2006
Last updated
08/27/2013
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