Individual
MARK DWIGHT GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3381 PHILLIS BLVD, MYRTLE BEACH, SC 29577-1560
(843) 477-0177
(843) 839-1791
Mailing address
3381 PHILLIS BLVD, MYRTLE BEACH, SC 29577-1560
(843) 477-0177
(843) 839-1791
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
13811
SC
Other
Enumeration date
07/27/2006
Last updated
09/23/2015
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