Organization
GLENN R. EDGECOMBE, MD,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN ROBERT EDGECOMBE M.D. (PHYSICIAN)
(301) 868-0150
Entity
Organization
Contact information
Practice address
7700 OLD BRANCH AVE, B201, CLINTON, MD 20735-1628
(301) 868-0150
(301) 868-0243
Mailing address
7700 OLD BRANCH AVE, B201, CLINTON, MD 20735-1628
(301) 868-0150
(301) 868-0243
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0023826
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020751900
—
MD
Enumeration date
10/15/2012
Last updated
10/15/2012
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