Provider Demographics
NPI:1972291730
Name:JENKINS, GLYNDWR WARREN (BCHD,MBBS(HONS),FRCS)
Entity Type:Individual
Prefix:MR
First Name:GLYNDWR
Middle Name:WARREN
Last Name:JENKINS
Suffix:
Gender:M
Credentials:BCHD,MBBS(HONS),FRCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 W. BALTIMORE STREET, UNIVERSITY OF MARYLAND SCHOOL
Mailing Address - Street 2:SUITE 1216
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201
Mailing Address - Country:US
Mailing Address - Phone:443-876-2758
Mailing Address - Fax:410-706-0891
Practice Address - Street 1:650 W. BALTIMORE STREET, UNIVERSITY OF MARYLAND SCHOOL
Practice Address - Street 2:SUITE 1216
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201
Practice Address - Country:US
Practice Address - Phone:410-706-3964
Practice Address - Fax:410-706-0891
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2024-02-09
Deactivation Date:2023-11-30
Deactivation Code:
Reactivation Date:2024-02-09
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program