Individual
DR. GLEN A. PU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
042921
GA
2085R0202X
Diagnostic Radiology Physician
DR.0074111
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000728351Q
—
GA
01
—
52614708 012
BCBS
GA
01
—
8BJ664
BCBS
TX
05
—
9000236416
—
CO
Enumeration date
11/07/2005
Last updated
07/13/2026
Update your record
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