Davis, Glen A

Davis, Glen A is an individual health care provider with primary practice located at 211 N Eddy St , South Bend IN 46617-2808. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Davis, Glen A can be contacted via phone (574) 233-7337.

Contact Information

Primary practice address
211 N Eddy St South Bend IN 46617-2808
Phone: (574) 233-7337
Fax: (574) 239-1561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01053925A Indiana

Profile Details

NPI number 1528058344
LBN Legal business name Davis, Glen A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Jun 6th, 2008 - about 17 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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