DR. Glen Joseph Booth, M.D.

NPI #1083740393 in Minneapolis, Minnesota

Provider Information

NPI Number: 1083740393
Entity Type: Individual
Name: DR. Glen Joseph Booth, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: General Practice
Credential: M.D.
Enumeration Date: Feb 23, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 1089 25TH AVE SE
City: Minneapolis
State: Minnesota
ZIP Code: 55414-2637
Phone: (612) 379-0212

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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