Individual
MARTHA JANE GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1950 CIRCLE OF HOPE DR, SALT LAKE CITY, UT 84112-5500
(801) 213-3800
Mailing address
PO BOX 413033, SALT LAKE CITY, UT 84141-3033
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
345070-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01008562
RAILROAD MEDICARE
UT
Enumeration date
10/13/2006
Last updated
09/12/2012
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