Provider Demographics
NPI:1447214770
Name:OREN, GLENN E (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:E
Last Name:OREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-4226
Mailing Address - Country:US
Mailing Address - Phone:970-249-6641
Mailing Address - Fax:970-249-5148
Practice Address - Street 1:910 S 4TH ST
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-4226
Practice Address - Country:US
Practice Address - Phone:970-249-6641
Practice Address - Fax:970-249-5148
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31554207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01315548Medicaid
COK9028Medicare ID - Type Unspecified
CO01315548Medicaid