Individual
DR. GLENN BAKER CHARLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2962 E STATE ST, HERMITAGE, PA 16148-2757
(724) 777-1895
(724) 591-8909
Mailing address
2418 JILLIAN LN, HERMITAGE, PA 16148-7728
(919) 724-9539
(724) 591-8909
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
200701478
NC
207P00000X
Emergency Medicine Physician
M5097
TX
207P00000X
Emergency Medicine Physician
MD019961E
PA
207Q00000X
Family Medicine Physician
Primary
MD019961E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000549072
—
PA
01
—
146GA
BCBS OF NC
NC
05
—
5907696
—
NC
Enumeration date
06/24/2007
Last updated
10/15/2021
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