Individual
DR. DOUGLAS JAMES GLENN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 GROVE RD FL 1, GREENVILLE, SC 29605-4210
(864) 455-8988
(864) 455-8981
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL35988
SC
2084P0800X
Psychiatry Physician
Primary
35988
SC
2084P0800X
Psychiatry Physician
LL35988
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259883
—
SC
Enumeration date
06/19/2013
Last updated
06/07/2021
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