| Glenn R. Edgecombe, Md,pc | |
|
7700 Old Branch Ave B201 Clinton MD 20735-1628 | |
| (301) 868-0150 | |
| (301) 868-0243 |
| Full Name | Glenn R. Edgecombe, Md,pc |
|---|---|
| Speciality | Family Medicine |
| Location | 7700 Old Branch Ave, Clinton, Maryland |
| Authorized Official Name and Position | Glenn Robert Edgecombe (PHYSICIAN) |
| Authorized Official Contact | 3018680150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glenn R. Edgecombe, Md,pc 7700 Old Branch Ave B201 Clinton MD 20735-1628 Ph: (301) 868-0150 | Glenn R. Edgecombe, Md,pc 7700 Old Branch Ave B201 Clinton MD 20735-1628 Ph: (301) 868-0150 |
| NPI Number | 1083966055 |
|---|---|
| Provider Enumeration Date | 10/15/2012 |
| Last Update Date | 10/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083966055 | NPI | - | NPPES |
| 020751900 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D0023826 (Maryland) | Primary |
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