Individual
DR. GLENN GORDON HAMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3512 STATE ROUTE 257, SUITE 106, SENECA, PA 16346-2946
(814) 677-3717
(814) 677-8914
Mailing address
3512 STATE ROUTE 257 STE 108, SENECA, PA 16346-2946
(814) 677-3717
(814) 677-8914
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD029612E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010113300004
—
PA
01
—
MD029612E
MEDICAL LICENSE
PA
Enumeration date
08/15/2005
Last updated
01/11/2021
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