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Contact Information

GLEN J IANNUCCI, M.D.
3300 OLD MILTON PKWY STE 100
ALPHARETTA, GA30005-2425
 Phone: 404-256-2593
 Fax: 770-488-9408
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Cardiology

2080P0202X 37 Physician/Pediatric Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for GLEN J IANNUCCI · (Male)

NPI Number 1972787760
Status Active
Credentials M.D.
Entity Individual
Enumeration date 12/28/2007
Last updated 04/23/2026 - About 1 months ago
Sole proprietor 1 No
Identifiers
  • GA License # 002845
  • GA License # 064569
  • GA Medicaid 003100495C
  • GA Other 002845 RESTRAINING PERMIT #
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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