Individual
GLENN A TUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-4000
Mailing address
125 METRO CENTER BLVD STE 2000, WARWICK, RI 02886-1785
(401) 432-2520
(401) 453-8220
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
53676
MA
2085R0202X
Diagnostic Radiology Physician
Primary
7914
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000001988
NHPRI
—
01
—
004390
BLUECHIP
—
01
—
007000616
HOSPITALPIN
—
01
—
007914
TUFTS
—
01
—
1600203
UNITEDHEALTHPLANS
—
01
—
240160
W & IPILGRIM
—
01
—
300036043
RAILROADMEDICARE
—
01
—
3043037
MASSMEDICAID
—
01
—
7000616
RIMEDICALASSISTANCE
—
01
—
720052201
CIGNA
—
01
—
7914
FEPBLUECROSS
—
Enumeration date
10/13/2005
Last updated
04/16/2024
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