Provider Demographics
NPI:1487669966
Name:GLINSKI, RONALD PETER (MD,)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:PETER
Last Name:GLINSKI
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:PO BOX 602530
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2530
Mailing Address - Country:US
Mailing Address - Phone:910-642-5832
Mailing Address - Fax:910-642-8814
Practice Address - Street 1:720 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3706
Practice Address - Country:US
Practice Address - Phone:910-642-5832
Practice Address - Fax:910-642-8814
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24655174400000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC412013319OtherRAIL ROAD MEDICARE
NC610997732OtherTRICARE
NC1920136OtherUNITED HEALTHCARE
NC24356OtherMEDCOST
SCN24655Medicaid
NCP00841858OtherRAILROAD MEDICARE
NC6554443OtherCIGNA
NC8935998Medicaid
NC35998OtherBLUE CROSS
NC1487669966Medicaid
NC6554443OtherCIGNA
NCB92502Medicare UPIN
SCN24655Medicaid