Individual
GLEN GEORGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
904 WOLLARD BLVD, RICHMOND, MO 64085-2229
(816) 470-5432
Mailing address
12810 N BELLFLOWER CT, PLATTE CITY, MO 64079-7808
(816) 510-0702
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
108171
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100344120A
—
KS
05
—
100344120B
—
KS
05
—
100344120C
—
KS
05
—
100344120D
—
KS
05
—
208516211
—
MO
01
—
25663033
BCBS
—
01
—
930079462
RAILROAD MEDICARE
—
Enumeration date
08/16/2006
Last updated
03/20/2019
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