Individual
GLENN NOEL POMERANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0000015600
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0393990001
DMERC GROUP NUMBER
TN
01
—
0452389
CIGNA PROVIDER NUMBER
TN
01
—
180029735
RAILRAOD MEDICARE
TN
01
—
3008472
MEDICARE
TN
01
—
36857
BLUE CROSS PROVIDER NUMBE
TN
01
—
3709593
MEDICARE GROUP NUMBER
TN
05
—
3709593
—
TN
01
—
4139738
AETNA PROVIDER NUMBER
TN
01
—
TN0101
JOHN DEERE PROVIDER NUMBE
TN
Enumeration date
08/22/2005
Last updated
01/25/2016
Update your record
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