Edgecombe, Glenn Robert

Edgecombe, Glenn Robert is an individual health care provider with primary practice located at 7700 Old Branch Ave Ste B201, Clinton MD 20735. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Edgecombe, Glenn Robert can be contacted via phone (301) 868-0150.

Contact Information

Primary practice address
7700 Old Branch Ave Ste B201 Clinton MD 20735
Phone: (301) 868-0150
Fax: (301) 868-0243
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X D0023826 Maryland

Profile Details

NPI number 1164485199
LBN Legal business name Edgecombe, Glenn Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1164485199 NPPES
District of Columbia Other 73810001 CAREFIRST BCBS
District of Columbia Other 855349 CAREFIRST BCBS
District of Columbia Other 494356 CAREFIRST BCBS
District of Columbia Other 41308904 CAREFIRST BCBS

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