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Individual

DR. GLENN L WING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6901 INTERNATIONAL CENTER BLVD, FT MYERS, FL 33912-7125
(239) 939-4323
(239) 939-3983
Mailing address
PO BOX 60559, FT MYERS, FL 33906-6559
(239) 939-4323
(239) 939-3983

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0039419
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
043884700
FL
01
180022163
RAILROAD MEDICARE
FL
05
374440000
FL
01
CA7010
RAILROAD MEDICARE GROUP
FL
Enumeration date
03/20/2006
Last updated
12/02/2008
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