Individual
DR. C. GLEN FERGUSON
Active
Individual
DR. C. GLEN FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
17205
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01172055
—
CO
01
—
17205
COLORADO STATE LICENSE
CO
05
—
94559040
—
CO
01
—
FE03792
BCBS
—
Enumeration date
09/22/2006
Last updated
03/07/2023
Update your record
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