MEDICARE: DR. GLENN STEVEN PFITZNER 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
1	207RG0100X	Gastroenterology Physician	9501055	NC

Other Identifiers

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

General Provider Information

NPI Number	:	1992799969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GLENN STEVEN PFITZNER MD

Provider Business Mailing Address
First Line	:	951 ROCKFORD ST
Second Line	:
City	:	MOUNT AIRY
State	:	NC
Zip	:	27030
Country	:	US
Telephone Number	:	336-719-7993
Fax Number	:	336-719-6550

Provider Business Practice Location Address
First Line	:	951 ROCKFORD ST
Second Line	:
City	:	MOUNT AIRY
State	:	NC
Zip	:	27030-5323
Country	:	US
Telephone Number	:	336-719-7993
Fax Number	:	336-719-6550

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	04/23/2008

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