GLEN LOY PORTWOOD


Address: 101 E Wt Harris Blvd Ste 3111, Charlotte, NC 28262-7002
Phone: 7045478818

GLEN LOY PORTWOOD (NPI# 1316965726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1316965726
Entity Type Individual
Full Name GLEN LOY PORTWOOD
Credential M.D.
Practice Address 101 E Wt Harris Blvd Ste 3111
Charlotte
NC 28262-7002
Mailing Address 11301 Carmel Commons Blvd
Ste 302
Charlotte
NC 28226-5305
Practice Telephone 7045478818
Practice Fax Number 7045479865
Mailing Telephone 7043727974
Mailing Fax Number 7043725166
Enumeration Date 2006-07-17
Last Update Date 2017-05-04
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RG0100X Internal Medicine
Specialization: Gastroenterology
9300570 NC Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC 5901259 05

Office Location

Street Address 101 E WT HARRIS BLVD STE 3111
City CHARLOTTE
State NC
Zip Code 28262-7002

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326066705 Fred Charles Fowler Internal Medicine 101 E Wt Harris Blvd Ste 3111, Charlotte, NC 28262-7002 2006-07-17
1669490991 Barry Randall Schneider Internal Medicine 101 E Wt Harris Blvd Ste 3111, Charlotte, NC 28262-7002 2006-07-17

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366056913 Aleta Michelle Johnson Specialist 9711 David Taylor Dr., Ste. 145, Charlotte, NC 28262 2020-09-01
1275161580 Londyn Homecare Agency L.l.c Home Health 1914j.n. Place, Charlotte, NC 28262 2020-03-31
1154964914 Abundant Love Home Care Service LLC In Home Supportive Care 1981 J.n. Pease Place, Ste 204, Charlotte, NC 28262 2019-10-24
1104399070 Nattya S Pilgreen Prosthetist 410 E Mccullough Drive, Suite 103, Charlotte, NC 28262 2019-01-03
1114404506 Laura Ida Anthony-getant Social Worker 10130 Mallard Creek Road, Ste 300 #333, Charlotte, NC 28262 2018-07-27
1720573587 Carolinas Center for Ambulatory Dentistry LLC Dentist 8415 Medical Plaza Drice, Charlotte, NC 28262 2018-06-25
1598254799 Cassandra Faye Harding Nurse Practitioner 1905 Jn Pease Place Suite 103, Charlotte, NC 28262 2018-05-03
1669960746 Michael Riley In Home Supportive Care 8301 University Exec Park Dr Ste 120, Charlotte, NC 28262 2018-04-25
1568989804 Bridget Coomber Behavior Technician 8420 University Executive Dr Ste 810, Charlotte, NC 28262 2017-08-28
1073037701 Toshana Daley Physical Therapist 8801 Jm Keynes Blvd, Charlotte, NC 28262 2017-08-03
Find all providers in zip 28262

Taxonomy Information

Taxonomy Code 207RG0100X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Gastroenterology

Taxonomy Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356778567 The Charlotte-mecklenburg Hospital Authority Internal Medicine 101 E W T Harris Blvd Bldg 3000, Ste 3301e, Charlotte, NC 28262-3485 2013-10-02
1528086980 Ronnie Cyzner Internal Medicine 10370 Park Rd Ste 102, Charlotte, NC 28210-8509 2006-07-17
1326066705 Fred Charles Fowler Internal Medicine 101 E Wt Harris Blvd Ste 3111, Charlotte, NC 28262-7002 2006-07-17
1124052444 Carolina Digestive Health Associates, Pa Internal Medicine 300 Billingsley Road, Suite 200, Charlotte, NC 28211 2006-07-11
1275566283 Preston Pemberton Purdum IIi Internal Medicine 300 Billingsley Rd Ste 200, Charlotte, NC 28211-1084 2006-07-10
1407814999 Dennis D Kokenes Internal Medicine 15830 John J Delaney Dr, Suite 175, Charlotte, NC 28277-3294 2006-05-03
1881007540 Nicolas Labarre Internal Medicine 1025 Morehead Medical Dr, Ste 300, Charlotte, NC 28204-2963 2014-06-10
1316365067 Victoria Maldonado Rothwell Internal Medicine 300 Billingsley Rd Ste 200, Charlotte, NC 28211-1180 2014-03-31
1053671586 Olanrewaju Yusuf Jimoh Internal Medicine 300 Billingsley Rd Ste 200, Charlotte, NC 28211 2012-05-17
1407144744 David Olson Internal Medicine 10502 Park Rd, Ste 150, Charlotte, NC 28210-8479 2011-07-20
Find all providers in CHARLOTTE

Competitor

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City CHARLOTTE
Zip Code 28262

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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