Individual
DR. GLENN A DAVISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1308 MORRIS AVENUE, SUITE 104, UNION, NJ 07083-3331
(908) 688-5577
(908) 688-2755
Mailing address
1308 MORRIS AVENUE, SUITE 104, UNION, NJ 07083-3331
(908) 688-5577
(908) 688-2755
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00196300
NJ
213E00000X
Podiatrist
N0046131
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245201
—
NJ
01
—
1K5292
HEALTH NET
—
01
—
3964640001
HEALTHNOW DMERC
—
01
—
4532318
AETNA
—
01
—
6200292
GHI
—
01
—
864965
UNITED HEALTH CARE
—
01
—
9350065
CIGNA HEALTH PLANS
—
01
—
P2215561
OXFORD
—
Enumeration date
08/30/2006
Last updated
12/07/2007
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