Individual
GLENN J LESSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
32761
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14713
PARTNERS
NC
05
—
191554000
—
WV
01
—
37370
MEDCOST
NC
01
—
51757
BCBS
NC
01
—
5212184
AETNA
—
05
—
6037208
—
VA
05
—
7951757
—
NC
05
—
Q32761
—
SC
Enumeration date
11/30/2005
Last updated
05/13/2008
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