Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 532 | MN |
NPI | 1265514731 |
---|---|
Provider Name | Dr. Glenn Robert Meints |
First Address | Duluth, MN 55812-1427 |
Second Address | Duluth, MN 55802-1760 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2700690 | MEDICA (01) | MN |
480034106 | RAILROAD MEDICARE (01) | MN |
767218700 | (05) | MN |
77342ME | BLUE CROSS BLUE SHIELD (01) | MN |
U50287 | (02) | MN |