Individual
GLEN D LIBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 JOHN ST, STE 352, KALAMAZOO, MI 49007-5341
(269) 341-8986
(269) 341-6236
Mailing address
601 JOHN ST, SUITE 352, KALAMAZOO, MI 49007-5341
(269) 341-8986
(269) 341-6236
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
4301050097
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1744625
—
MI
Enumeration date
01/19/2006
Last updated
10/16/2014
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