Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

George Russell Glenn, MDPHD

Individual provider Diagnostic Radiology Physician · NPI 1396239125

George Russell Glenn, MDPHD is a Diagnostic Radiology in Dallas, Texas. Graduated from Medical University of South Carolina College of Medicine in 2018, 8 years ago. Practices with Cira Michigan PC, a 90-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida, Georgia, Illinois and Michigan.

Years since qualifying
8
Trained at
Medical University of South Carolina College of Medicine
Licensed in
FL, GA, IL, MI
In the registry since
2018
Specialties on file
4
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Practice location Address checks out

2825 Oak Lawn Ave Unit 192749
Dallas, TX 75219-4688
Phone: (510) 683-9500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Internal Medicine Clinic, Columbia, SC 29203 — (803) 434-4153

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence ME176998 (FL)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 4301515727 (MI)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 95127 (GA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 036165017 (IL)

Record details

NPI number1396239125
Entity typeIndividual (Type 1)
GenderMale
Credentials MDPHD
Sole proprietorNo
NPI enumeratedJune 15, 2018
Last updated in NPPESJanuary 5, 2026
Certification dateJanuary 5, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolMEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Cira Michigan Pc — 90 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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