# GLEGEN MEDICAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093663023
- **Authorized official:** DR. GLEB GENDEL DO (SOLE MBR)
- **Authorized official phone:** (877) 340-1697

## Contact information

- **Practice address:** 5165 NORTHLAND DR NE, GRAND RAPIDS, MI 49525-1015
- **Practice address phone:** (877) 340-1697
- **Mailing address:** 5165 NORTHLAND DR NE, GRAND RAPIDS, MI 49525-1015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/17/2026
- **Last updated:** 10/06/2026