NPI 1104852367

Jerry Glowniak, MD

Practitioner Specialist Southfield, MI

Practice location

Address: 24500 Northwestern Hwy, Southfield, MI 48075-2414
Phone: (248) 353-1280
Fax: (248) 353-6193

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 4301038010 (MI)

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Registry record

NPI: 1104852367
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Jun 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.