Individual
MICHAEL L GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
26 FARRAGUT AVE, MEDFORD, MA 02155-4012
(781) 396-6424
Mailing address
26 FARRAGUT AVE, MEDFORD, MA 02155-4012
(781) 396-6424
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
33847
MA
Other
Enumeration date
02/05/2007
Last updated
07/08/2007
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