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DR. GLEN JOSEPH IANNUCCI M.D. NPI 1972787760


NPI Information

NPI: 1972787760
Provider Name: DR. GLEN JOSEPH IANNUCCI, M.D.
Classification: Pediatrics - 2080P0202X
Entity Type: Individual

Specialization: Pediatric Cardiology

Organization: EMORY EGLESTON CHILDRENS HEART CENTER

PECOS Registration: Yes

Address:
3300 OLD MILTON PKWY STE 100
ALPHARETTA, GA
ZIP 30005
Phone: (404) 256-2593
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DR. Glen Joseph Iannucci, M.D. is a pediatric cardiology pediatrics in Alpharetta, GA with 17 years of experience. The provider is a pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. DR. Glen Joseph Iannucci, M.D. NPI is 1972787760. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduation Year:2007

The provider's business location address is:

3300 OLD MILTON PKWY STE 100
ALPHARETTA, GA
ZIP 30005-425
Phone: (404) 256-2593
Fax: (770) 488-9408

The NPI 1972787760 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/28/2007 and was last updated on 1/22/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics002845GEORGIANo
22080P0202XPediatricsPediatric Cardiology064569GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1003100495CMEDICAIDGEORGIA
2002845OTHERGEORGIARESTRAINING PERMIT #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.