Individual
DR. MEL B GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 NASHUA ST, SRH, BOSTON, MA 02114-1198
(617) 573-2625
(617) 573-2769
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 573-2625
(617) 573-2769
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
49226
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0181749
—
MA
01
—
049226
TUFTS HEALTH PLAN
MA
01
—
E05923
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
08/16/2012
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