Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 231110 | MA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 35.136731 | OH |
NPI | 1639205214 |
---|---|
Provider Name | Michael P Glotzbecker |
First Address | Cleveland, OH 44106 |
Second Address | Cleveland, OH 44106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 30/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0366400 | (05) | OH |