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Individual

GLENN RICHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
22 S GREENE ST, DEPT OF RADIOLOGY, BALTIMORE, MD 21201-1544
(410) 328-3477
Mailing address
22 S GREENE ST, DEPT OF RADIOLOGY, BALTIMORE, MD 21201-1544
(410) 328-3477

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
H0071490
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
070255600
DC
05
339604500
MD
Enumeration date
03/29/2006
Last updated
04/26/2019
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