GLEN LOY PORTWOOD (NPI# 1316965726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316965726 |
| Entity Type | Individual |
| Full Name | GLEN LOY PORTWOOD |
| Credential | M.D. |
| Practice Address |
101 E Wt Harris Blvd Ste 3111 Charlotte NC 28262-7002 |
| Mailing Address |
11301 Carmel Commons Blvd Ste 302 Charlotte NC 28226-5305 |
| Practice Telephone | 7045478818 |
| Practice Fax Number | 7045479865 |
| Mailing Telephone | 7043727974 |
| Mailing Fax Number | 7043725166 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2017-05-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
9300570 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 5901259 | 05 |
| Street Address |
101 E WT HARRIS BLVD STE 3111 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28262-7002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326066705 | Fred Charles Fowler | Internal Medicine | 101 E Wt Harris Blvd Ste 3111, Charlotte, NC 28262-7002 | 2006-07-17 |
| 1669490991 | Barry Randall Schneider | Internal Medicine | 101 E Wt Harris Blvd Ste 3111, Charlotte, NC 28262-7002 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366056913 | Aleta Michelle Johnson | Specialist | 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 | 2020-09-01 |
| 1275161580 | Londyn Homecare Agency L.l.c | Home Health | 1914j.n. Place, Charlotte, NC 28262 | 2020-03-31 |
| 1154964914 | Abundant Love Home Care Service LLC | In Home Supportive Care | 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 | 2019-10-24 |
| 1104399070 | Nattya S Pilgreen | Prosthetist | 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 | 2019-01-03 |
| 1114404506 | Laura Ida Anthony-getant | Social Worker | 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 | 2018-07-27 |
| 1720573587 | Carolinas Center for Ambulatory Dentistry LLC | Dentist | 8415 Medical Plaza Drice, Charlotte, NC 28262 | 2018-06-25 |
| 1598254799 | Cassandra Faye Harding | Nurse Practitioner | 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 | 2018-05-03 |
| 1669960746 | Michael Riley | In Home Supportive Care | 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 | 2018-04-25 |
| 1568989804 | Bridget Coomber | Behavior Technician | 8420 University Executive Dr Ste 810, Charlotte, NC 28262 | 2017-08-28 |
| 1073037701 | Toshana Daley | Physical Therapist | 8801 Jm Keynes Blvd, Charlotte, NC 28262 | 2017-08-03 |
| Find all providers in zip 28262 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356778567 | The Charlotte-mecklenburg Hospital Authority | Internal Medicine | 101 E W T Harris Blvd Bldg 3000, Ste 3301e, Charlotte, NC 28262-3485 | 2013-10-02 |
| 1528086980 | Ronnie Cyzner | Internal Medicine | 10370 Park Rd Ste 102, Charlotte, NC 28210-8509 | 2006-07-17 |
| 1326066705 | Fred Charles Fowler | Internal Medicine | 101 E Wt Harris Blvd Ste 3111, Charlotte, NC 28262-7002 | 2006-07-17 |
| 1124052444 | Carolina Digestive Health Associates, Pa | Internal Medicine | 300 Billingsley Road, Suite 200, Charlotte, NC 28211 | 2006-07-11 |
| 1275566283 | Preston Pemberton Purdum IIi | Internal Medicine | 300 Billingsley Rd Ste 200, Charlotte, NC 28211-1084 | 2006-07-10 |
| 1407814999 | Dennis D Kokenes | Internal Medicine | 15830 John J Delaney Dr, Suite 175, Charlotte, NC 28277-3294 | 2006-05-03 |
| 1881007540 | Nicolas Labarre | Internal Medicine | 1025 Morehead Medical Dr, Ste 300, Charlotte, NC 28204-2963 | 2014-06-10 |
| 1316365067 | Victoria Maldonado Rothwell | Internal Medicine | 300 Billingsley Rd Ste 200, Charlotte, NC 28211-1180 | 2014-03-31 |
| 1053671586 | Olanrewaju Yusuf Jimoh | Internal Medicine | 300 Billingsley Rd Ste 200, Charlotte, NC 28211 | 2012-05-17 |
| 1407144744 | David Olson | Internal Medicine | 10502 Park Rd, Ste 150, Charlotte, NC 28210-8479 | 2011-07-20 |
| Find all providers in CHARLOTTE | ||||
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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.