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Individual

GLENN FREEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 GRAND ST, DELPHI ORTHOPEDIC CLINIC ON C-1, NEW BRITAIN, CT 06052-2016
(860) 224-5540
(860) 224-5942
Mailing address
PO BOX 339, ENGLEWOOD, FL 34295-0339
(941) 223-0555

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101040787
VA
207X00000X
Orthopaedic Surgery Physician
015946
ME
207X00000X
Orthopaedic Surgery Physician
2007-00852
NC
207X00000X
Orthopaedic Surgery Physician
214250
MA
207X00000X
Orthopaedic Surgery Physician
84747
FL
207X00000X
Orthopaedic Surgery Physician
Primary
ME84747
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MM968902
MEDICARE PTAN
NH
Enumeration date
02/14/2006
Last updated
01/07/2014
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