Glenn R. Kershaw
Nephrologist
55 Lake Ave N Department Of Nephrology
Worcester
, Massachusetts 01655-0002
Glenn R. Kershaw
Nephrologist
55 Lake Ave N Department Of Nephrology
Worcester
, Massachusetts 01655-0002
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About
Features
Specialties
- Nephrologist
Languages spoken
- English
Location
First Address
- Glenn R. Kershaw
- Po Box 415348
- Boston, MA
- Zip : 02241-5348
- Phone :
Second Address
- Glenn R. Kershaw
- 55 Lake Ave N Department Of Nephrology
- Worcester, MA
- Zip : 01655-0002
- Phone : (508) 856-3155
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RN0300X | Nephrologist | 39777 | MA |
National Provider Identifier
| NPI | 1023092939 |
|---|---|
| Provider Name | Glenn R. Kershaw |
| First Address | Boston, MA 02241-5348 |
| Second Address | Worcester, MA 01655-0002 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/12/2005 |
| Last Update Date | 26/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 110037545A | (05) | MA |
| B72683 | (02) | MA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.