Individual
DR. GLENN R. WILLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 MEDICAL PARK DR, MEBANE, NC 27302-7639
(919) 563-2500
(919) 563-3535
Mailing address
PO BOX 1717, BURLINGTON, NC 27216-1717
(336) 538-1234
(336) 538-2390
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
95-00476
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8987638
—
NC
Enumeration date
07/20/2006
Last updated
06/28/2013
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