Individual
DR. GLENN ROBERT EDGECOMBE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7700 OLD BRANCH AVE, STE B201, CLINTON, MD 20735
(301) 868-0150
(301) 868-0243
Mailing address
7700 OLD BRANCH AVE, STE B201, CLINTON, MD 20735
(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
01
—
41308904
CAREFIRST BCBS
MD
01
—
494356
NCPPO
MD
01
—
73810001
CAREFIRST BCBS
DC
01
—
855349
MAMSI
MD
Enumeration date
04/10/2006
Last updated
07/08/2007
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