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Individual

MR. GLENN RAY CARWELL JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 FIRST COLONIAL RD STE 100, VIRGINIA BEACH, VA 23454-2274
(757) 481-7788
(757) 481-1707
Mailing address
1200 FIRST COLONIAL RD STE 100, VIRGINIA BEACH, VA 23454-2274
(757) 481-7788
(757) 481-1707

Taxonomy

Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
0101025726
VA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
0101025726
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
261400
ANTHEM
VA
05
7905293
NC
Enumeration date
08/20/2006
Last updated
11/07/2019
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