Individual
DR. GLEN KENNETH PROVIDENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
197 E SILVER ST, SUITE 2, SHARON, PA 16146-2186
(724) 342-6604
(724) 342-1601
Mailing address
100 SHENANGO AVE, SHARON, PA 16146-1503
(724) 342-6604
(724) 342-1601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD443812
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0059701
—
OH
05
—
1026452400001
—
PA
01
—
P010166
GATEWAY
PA
Enumeration date
09/24/2010
Last updated
12/11/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us