Individual
GLENN WILLIAM POTTMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2231 CAREW ST, FORT WAYNE, IN 46805-4713
(260) 266-7856
(260) 266-5279
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
5101026112
MI
207RP1001X
Pulmonary Disease Physician
Primary
02007826A
IN
207RP1001X
Pulmonary Disease Physician
5101026112
MI
390200000X
Student in an Organized Health Care Education/Training Program
5101026112
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/29/2018
Last updated
08/02/2024
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