Individual
GLENN A DELONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1000 HARRINGTON BLVD, MT CLEMENS, MI 48043
(586) 493-8000
Mailing address
PO BOX 8836, GRAND RAPIDS, MI 49518
(866) 898-7139
(616) 975-9824
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
51010103414
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0155025145
BCBS
—
05
—
112877321
—
MI
Enumeration date
06/22/2006
Last updated
05/16/2008
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