Booth, Glen Joseph

Booth, Glen Joseph is an individual health care provider with primary practice located at 1089 25Th Ave Se , Minneapolis MN 55414-2637. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Booth, Glen Joseph can be contacted via phone (612) 379-0212.

Contact Information

Primary practice address
1089 25Th Ave Se Minneapolis MN 55414-2637
Phone: (612) 379-0212
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X B29991 Minnesota

Profile Details

NPI number 1083740393
LBN Legal business name Booth, Glen Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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