Individual
DR. GLEN THOMAS SEWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 STARDUST ST, STE D, RENO, NV 89503-4264
(775) 746-3400
(775) 746-3411
Mailing address
1350 STARDUST ST, STE D, RENO, NV 89503-4264
(775) 746-3400
(775) 746-3411
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
3580
NV
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
G38179
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XPY068120
MEDICAL
NV
Enumeration date
06/09/2005
Last updated
07/09/2007
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