Organization
TROY PODIATRIST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN GLICKMAN DPM (OWNER)
(248) 689-5125
Entity
Organization
Contact information
Practice address
4770 ROCHESTER RD, SUITE 104, TROY, MI 48085-4951
(248) 689-5125
(248) 689-5688
Mailing address
4770 ROCHESTER RD, SUITE 104, TROY, MI 48085-4951
(248) 689-5125
(248) 689-5688
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SG000600
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1375192-13
—
MI
01
—
480013308
RAILROAD MEDICARE
MI
01
—
C2490
MCARE
MI
Enumeration date
09/25/2006
Last updated
08/27/2009
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