Individual
DR. GLENN BRADFORD PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2826 RANDOLPH RD, CHARLOTTE, NC 28211-1019
(704) 358-0308
(704) 358-0039
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 358-0308
(704) 358-0039
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
26968
NC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
26968
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8966884
—
NC
Enumeration date
06/22/2005
Last updated
03/12/2015
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