Individual
GLENN C WEBSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
557 BROOKDALE DR, STATESVILLE, NC 28677-4107
(704) 873-5661
Mailing address
548 BROOKDALE DR, STATESVILLE, NC 28677-4108
(704) 872-6122
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4301074365
MI
2085R0202X
Diagnostic Radiology Physician
Primary
81374
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700D711230
BCBS OF MICHIGAN
MI
01
—
700H160030
BCBS OF MICHIGAN
MI
Enumeration date
09/15/2006
Last updated
12/17/2021
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