# REVOLUTION MEDICINE HEALTH & FITNESS PLLC

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

## Provider details

- **NPI number:** 1245887959
- **Authorized official:** DR. MICHAEL L GLICKMAN MD (PHYSICIAN)
- **Authorized official phone:** (202) 596-8891

## Contact information

- **Practice address:** 1050 CONNECTICUT AVE NW STE 500, WASHINGTON, DC 20036-5304
- **Practice address phone:** (202) 596-8891
- **Practice address fax:** (304) 245-6029
- **Mailing address:** 1050 CONNECTICUT AVE NW STE 500, WASHINGTON, DC 20036-5304
- **Mailing address phone:** (202) 596-8891
- **Mailing address fax:** (304) 245-6029

## Taxonomy

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

## Other

- **Enumeration date:** 08/19/2019
- **Last updated:** 05/19/2026