Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | ME11588 | FL |
N | 2086S0105X | Surgery of the Hand | ME11588 | FL |
NPI | 1922079565 |
---|---|
Provider Name | Glen Arthur Barden |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-6601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 02/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
069532700 | (05) | FL |
53414 | BLUE CROSS BLUE SHIELD (01) | FL |
D56503 | (02) |