Provider Demographics
NPI:1063444602
Name:CRATER, GLENN D (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:D
Last Name:CRATER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8801 FAST PARK DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-4852
Mailing Address - Country:US
Mailing Address - Phone:650-808-4078
Mailing Address - Fax:
Practice Address - Street 1:1390 CAPITAL BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1118
Practice Address - Country:US
Practice Address - Phone:919-836-1642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200500345207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease