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Individual

GLEN IRVING REEVES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D., M.P.H.

Contact information

Practice address
8211 TERMINAL RD, NORTHROP GRUMMAN IT, SUITE 1000, LORTON, VA 22079-1435
(703) 767-2361
Mailing address
8211 TERMINAL RD, NORTHROP GRUMMAN IT, SUITE 1000, LORTON, VA 22079-1435
(703) 767-2361

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
0101236997
VA
174400000X
Specialist
Primary
0101236997
VA

Other

Enumeration date
06/11/2008
Last updated
06/11/2008
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