Individual
DR. RONALD M GLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3940 E UNIVERSITY DR, MESA, AZ 85205-6945
(480) 924-9235
(480) 832-5501
Mailing address
3940 E UNIVERSITY DR, MESA, AZ 85205-6945
(480) 924-9235
(480) 832-5501
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2012
AZ
207NP0225X
Pediatric Dermatology Physician
2012
AZ
207NS0135X
Procedural Dermatology Physician
2012
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278938
—
AZ
Enumeration date
06/15/2005
Last updated
02/09/2022
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