Individual
GLEN R WILENSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7406 BROOK RD, RICHMOND, VA 23227-1817
(804) 262-7153
(804) 262-0104
Mailing address
7406 BROOK RD, RICHMOND, VA 23227-1817
(804) 262-7153
(804) 262-0104
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
VA 0103000938
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01021914
—
VA
01
—
172333
ANTHEM
VA
Enumeration date
06/28/2005
Last updated
08/19/2010
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