Individual
DR. MARVIN H GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(800) 721-4177
Mailing address
PO BOX 64000, DWR 641554, DETROIT, MI 48264-0001
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
5101008583
MI
Other
Enumeration date
08/22/2006
Last updated
09/20/2012
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