Gardner, Glendon M.
Gardner, Glendon M. is an individual health care provider with primary practice located at 6777 W Maple Rd , West Bloomfield MI 48322-3013. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Gardner, Glendon M. can be contacted via phone (248) 661-7211.Contact Information
Primary practice address
6777 W Maple Rd
West Bloomfield MI 48322-3013
Phone: (248) 661-7211
Fax: (248) 661-6456
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 063874 | Michigan |
Profile Details
| NPI number | 1871669242 |
|---|---|
| LBN Legal business name | Gardner, Glendon M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 28th, 2006 |
| Last updated | Mar 10th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871669242 | NPPES |
| Other | GG063874 | CHAMPUS-CHAMPUS | |
| Other | 700H262260 | CHAMPUS-CHAMPUS | |
| MEDICAID | 307008110 | CHAMPUS-CHAMPUS | |
| Other | GG063874 | CHAMPUS-CHAMPUS |
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