Provider Demographics
NPI:1760446611
Name:CURDA, GLEN A (DPM)
Entity Type:Individual
Prefix:DR
First Name:GLEN
Middle Name:A
Last Name:CURDA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 156TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-6300
Mailing Address - Country:US
Mailing Address - Phone:425-746-5996
Mailing Address - Fax:
Practice Address - Street 1:2950 NORTHUP WAY
Practice Address - Street 2:SUITE 115
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-1406
Practice Address - Country:US
Practice Address - Phone:425-893-8100
Practice Address - Fax:425-893-8111
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-16
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA301213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT01574Medicare UPIN
WA000101139Medicare ID - Type Unspecified