Provider Demographics
NPI:1720038342
Name:FUCHS, GLENN H (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:H
Last Name:FUCHS
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 1:6565 ARLINGTON BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-3000
Mailing Address - Country:US
Mailing Address - Phone:703-578-1770
Mailing Address - Fax:703-820-7088
Practice Address - Street 1:6565 ARLINGTON BLVD STE 102
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3000
Practice Address - Country:US
Practice Address - Phone:703-578-1770
Practice Address - Fax:703-820-7088
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD12067207N00000X
VA0101033724207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
814870OtherAETNA
VA060386OtherANTHEM BLUESHIELD OF VA
VA133076OtherMEDICARE PTAN
DC15460001OtherCAREFIRST BLUECROSS BLUESHIELD
VADN8752OtherRR MEDICARE PTAN
VADN8752OtherRR MEDICARE PTAN
DC15460001OtherCAREFIRST BLUECROSS BLUESHIELD