Individual
IVAN GLOTOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1240 EAGLES LANDING PKWY STE 300, STOCKBRIDGE, GA 30281-5173
(770) 506-4350
(770) 506-9860
Mailing address
3100 INTERSTATE NORTH CIR SE STE 500, ATLANTA, GA 30339-2296
(678) 996-7230
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/11/2025
Last updated
04/11/2025
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