Individual
GLENN ALAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
385 RTE 24, STE 1C, CHESTER, NJ 07930-2918
(908) 879-6277
(908) 879-4464
Mailing address
PO BOX 634, CHESTER, NJ 07930-0634
(908) 879-6277
(908) 879-4464
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA56172
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5002109
—
NJ
Enumeration date
09/14/2005
Last updated
10/22/2007
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