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Individual
GLENN STALL
Active
Individual
GLENN STALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
9801510
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126WG
BCBS
NC
01
—
460003102
MCR RR
NC
05
—
89126WG
—
NC
01
—
P00629153
RR MEDICARE
NC
Enumeration date
03/10/2006
Last updated
08/25/2026
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