Provider Demographics
NPI:1992455919
Name:GLYNN, DAVID (MB BCH BAO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GLYNN
Suffix:
Gender:M
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BRIGHAM AND WOMEN'S HOSPITAL
Mailing Address - Street 2:75 FRANCIS STREET
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-5500
Mailing Address - Fax:
Practice Address - Street 1:QUERN, THORNBACK HILL
Practice Address - Street 2:THORNBACK HILL
Practice Address - City:KILKENNY
Practice Address - State:KILKENNY
Practice Address - Zip Code:R95PV06
Practice Address - Country:IE
Practice Address - Phone:085-133-9469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program