Provider Demographics
NPI:1841390150
Name:NEWELL, GLENN C (MD)
Entity Type:Individual
Prefix:MR
First Name:GLENN
Middle Name:C
Last Name:NEWELL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 COOPER PLAZA
Mailing Address - Street 2:THE COOPER HOSPITALIST TEAM
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-342-3150
Mailing Address - Fax:856-968-8418
Practice Address - Street 1:1 COOPER PLAZA
Practice Address - Street 2:THE COOPER HOSPITALIST TEAM
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-342-3150
Practice Address - Fax:856-968-8418
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2014-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA42485207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2795437OtherCIGNA
NJ1392808Medicaid
NJ223310529OtherJERSEY MED
NJ1078072OtherHORIZON NJ HEALTH
NJ3K6191OtherHEALTHNET, INC
NJ587759OtherAMERIHEALTH PPO PABS
NJ123449OtherAETNA USHEALTHCARE
NJ1242075OtherUNITED HEALTHCARE
NJ0409662000OtherAMERIHEALTH HMO
NJ1173238OtherHORIZON NJ HEALTH
NJ37142OtherAMERIGROUP
NJCA0000012OtherAMERICHOICE
NJ13605OtherUNIVERSITY HEALTH PLAN
NJJP067OtherOXFORD
NJC58255Medicare UPIN
NJNE58779Medicare ID - Type UnspecifiedMEDICARE
NJ587759Medicare PIN