DR. GLENN ROBERT EDGECOMBE (NPI# 1164485199) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164485199 |
| Entity Type | Individual |
| Full Name | DR. GLENN ROBERT EDGECOMBE |
| Credential | MD |
| Practice Address |
7700 Old Branch Ave Ste B201 Clinton MD 20735 |
| Practice Telephone | 3018680150 |
| Practice Fax Number | 3018680243 |
| Mailing Telephone | 3018680150 |
| Mailing Fax Number | 3018680243 |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | D0023826 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | NCPPO | 494356 | 01 |
| MD | MAMSI | 855349 | 01 |
| MD | CAREFIRST BCBS | 41308904 | 01 |
| DC | CAREFIRST BCBS | 73810001 | 01 |
| Street Address |
7700 OLD BRANCH AVE STE B201 |
| City | CLINTON |
| State | MD |
| Zip Code | 20735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568468841 | Philip L Briley | Psychologist | 7700 Old Branch Ave, Ste B105, Clinton, MD 20735-1628 | 2005-06-22 |
| 1003264243 | Mind Over Matter Health Services | Community/Behavioral Health | 7700 Old Branch Ave, B204, Clinton, MD 20735-1628 | 2016-05-27 |
| 1982050472 | Hagar Healthcare | Occupational Therapist | 7700 Old Branch Ave, Suite E 208, Clinton, MD 20735-1628 | 2016-05-13 |
| 1164889390 | Gregory Beacham II | Massage Therapist | 7700 Old Branch Ave, Clinton, MD 20735-1628 | 2016-01-19 |
| 1013389121 | Brittany Deloatch | Counselor | 7700 Old Branch Ave, D103, Clinton, MD 20735-1628 | 2015-10-28 |
| 1750775268 | Southern Maryland Endoscopy Center Anesthesia | Internal Medicine | 7700 Old Branch Ave, Suite A103, Clinton, MD 20735-1628 | 2015-03-23 |
| 1356739098 | John P. Hakim, Md and Associates | Internal Medicine | 7700 Old Branch Ave, Suite E105, Clinton, MD 20735-1628 | 2015-01-05 |
| 1528466190 | Petra Patterson | Nursing Home Administrator | 7700 Old Branch Ave, Clinton, MD 20735-1628 | 2014-12-15 |
| 1427455088 | Deanna Sharpe | Nurse Practitioner | 7700 Old Branch Ave, D203, Clinton, MD 20735-1628 | 2014-11-25 |
| 1760889497 | Floss Family Dentistry, LLCs | Dentist | 7700 Old Branch Ave, D105, Clinton, MD 20735-1628 | 2014-11-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940456 | Elise Olson | Occupational Therapist | 9135 Piscataway Rd, Suite 305, Clinton, MD 20735 | 2019-03-12 |
| 1437651742 | Total You Integrative Healthcare Inc | Clinic/Center | 9135 Piscataway Rd Ste 410, Clinton, MD 20735 | 2018-03-02 |
| 1386193233 | Benedicta C Osamor | Home Health Aide | 6808 Purple Lilac Ln, Clinton, MD 20735 | 2016-10-03 |
| 1669926309 | Frankline Ngozi Obi I | Home Health Aide | 8111 Highland Meadows Dr, Clinton, MD 20735 | 2016-08-11 |
| 1770952459 | Adventures One, Inc. | Clinic/Center | 7121 Old Alexandria Ferry Rd., Clinton, MD 20735 | 2015-09-23 |
| 1730574831 | Lindsey Degeorge | Emergency Medicine | 7503 Surratts Rd Dept Of, Clinton, MD 20735 | 2015-04-06 |
| 1316341860 | Margaret Laurence-whitlock | Speech-Language Pathologist | 5807 Terence Dr., Laurence Learning Center, Clinton, MD 20735 | 2014-10-13 |
| 1699103622 | Dcps | Social Worker | 5504 Trout Run Rd, Clinton, MD 20735 | 2013-10-30 |
| 1902232614 | Rafael Antonio Acosta | Dentist | 7905 Malcolm Rd Ste 300, Clinton, MD 20735 | 2013-09-25 |
| 1407135874 | Richelle Wilson Harvey | Occupational Therapist | 8202 Shackelford Way, Clinton, MD 20735 | 2011-08-16 |
| Find all providers in zip 20735 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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|---|---|---|---|---|
| 1689217978 | Springridge Medical Clinic | Family Medicine | 507 Springridge Rd Ste A, Clinton, MS 39056-5628 | 2019-10-20 |
| 1578125837 | Dana Fuller | Family Medicine | 600 Plaza Cir, Clinton, SC 29325-7555 | 2019-07-07 |
| 1477057966 | Strong Health & Wellness Center, LLC | Family Medicine | 130 Fairmont St Ste B, Clinton, MS 39056-4714 | 2018-03-20 |
| 1841650348 | St. Luke's Warren Physician Group, PC | Family Medicine | 22 Walmart Plaza, Clinton, NJ 08809 | 2016-02-26 |
| 1851762173 | Olive Tree Medical Associates Pllc | Family Medicine | 7505 Foote Rd, Clinton, NY 13323-3403 | 2015-10-13 |
| 1356789341 | Clinton Hmpn, LLC | Family Medicine | 129 S. 9th Street, Clinton, OK 73601 | 2013-06-12 |
| 1437458601 | Sally A Goodwin | Family Medicine | 3677 Woodland Hall Ln, Clinton, WA 98236-8628 | 2011-03-27 |
| 1578886610 | University Health System, Inc | Family Medicine | 2681 Andersonville Hwy, Ste 102, Clinton, TN 37716-6706 | 2010-03-03 |
| 1720313075 | Eva Cesnek Novak | Family Medicine | 54 Old Route 22, Clinton, NJ 08809-4137 | 2009-10-05 |
| 1437388055 | Scott Chasley Martin | Family Medicine | 732 Clinton Pkwy, Clinton, MS 39056-5227 | 2009-07-02 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.