Individual
DR. GLENN ASHLEY WITHROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1728 FORDHAM BLVD, 151 RAMS PLAZA, CHAPEL HILL, NC 27514-2397
(919) 968-1985
(919) 942-0038
Mailing address
1728 FORDHAM BLVD, 151 RAMS PLAZA, CHAPEL HILL, NC 27514
(919) 968-1985
(919) 942-0038
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27884
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203572B
PTAN
NC
01
—
88667
NC BLUE CROSS BLUE SHIELD ID#
NC
Enumeration date
07/14/2006
Last updated
02/13/2013
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