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NPI Code Detail

MEDICARE: GLENN ALAN DAVIS MD

MEDICARE:   GLENN ALAN DAVIS  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMA56172NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740275858
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENN ALAN DAVIS MD
Provider Business Mailing Address
First Line : PO BOX 634
Second Line :
City : CHESTER
State : NJ
Zip : 07930-0634
Country : US
Telephone Number : 908-879-6277
Fax Number : 908-879-4464
Provider Business Practice Location Address
First Line : 385 RTE 24
Second Line : STE 1C
City : CHESTER
State : NJ
Zip : 07930-2918
Country : US
Telephone Number : 908-879-6277
Fax Number : 908-879-4464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2005
Last Update Date : 10/22/2007

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Directions to “ GLENN ALAN DAVIS MD” Practice Location

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