Glenn R. Edgecombe, MD,PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0023826 Issued in MD

Legal business name

GLENN R. EDGECOMBE, MD,PC

Practice address

7700 Old Branch Ave
B201
Clinton, MD 20735-1628

Phone

(301) 868-0150

Fax

(301) 868-0243

NPI assigned

Oct 15, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Glenn Robert Edgecombe, M.D.

Title

Physician

Phone

(301) 868-0150

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1083966055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 OLD BRANCH AVE",
            "address_2": "B201",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351628",
            "telephone_number": "301-868-0150",
            "fax_number": "301-868-0243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 OLD BRANCH AVE",
            "address_2": "B201",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351628",
            "telephone_number": "301-868-0150",
            "fax_number": "301-868-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN R. EDGECOMBE, MD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "EDGECOMBE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "301-868-0150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0023826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020751900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Giant of Maryland LLC
• Latyra Gibbs, MD
• George E. Gilbert, M.D., PH.D.
• Michael Gillespie, M.D.
• Molly Louvnia Gilmore, CNA
• Lexie A Glover, CRNA
• Golden Key Dental ,LLC
• Golden Touch
• Breanna Gomez, LGPC
• Jacqueline Yessenia Gonzalez

• Family Medicine Physician in Clinton, MD
• Providers in Clinton, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.