Provider Demographics
NPI:1386677540
Name:GIESSEL, GLENN M (MD)
Entity Type:Individual
Prefix:
First Name:GLENN
Middle Name:M
Last Name:GIESSEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1000 BOULDERS PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-5545
Mailing Address - Country:US
Mailing Address - Phone:804-320-4243
Mailing Address - Fax:804-622-0552
Practice Address - Street 1:1000 BOULDERS PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-5545
Practice Address - Country:US
Practice Address - Phone:804-320-4243
Practice Address - Fax:804-622-0552
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2021-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101031697207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA557151OtherAETNA NON-HMO
VA766609OtherMAMSI
VA021782OtherCIGNA
VA188410OtherANTHEM
VA006069991Medicaid
VA2061582OtherAETNA HMO
VA188410OtherANTHEM HEALTHKEEPERS
VA290003783OtherMEDICARE RAILROAD
VA4800157OtherUNITED HEALTHCARE
VA30987OtherCARENET
VA59247OtherSOUTHERN HEALTH
VA006895400OtherBLACK LUNG
VA4800157OtherUNITED HEALTHCARE
VA557151OtherAETNA NON-HMO