Individual
CHRIS GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2741 DEBARR RD, SUITE 401, ANCHORAGE, AK 99508-2961
(907) 792-7975
(907) 792-7901
Mailing address
PO BOX 140349, ANCHORAGE, AK 99514-0349
(907) 792-7975
(907) 792-7901
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
8122
AK
2085R0202X
Diagnostic Radiology Physician
G79975
CA
2085R0204X
Vascular & Interventional Radiology Physician
8122
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G799750
BLUE SHIELD OF CA
CA
05
—
00G799750
—
CA
05
—
1457315533
—
CA
Enumeration date
04/14/2006
Last updated
09/24/2015
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