Individual
DR. S VIC GLOGOVAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12255 DE PAUL DR, SUITE 165, BRIDGETON, MO 63044-2510
(314) 291-7510
(314) 291-0001
Mailing address
12255 DE PAUL DR, SUITE 165, BRIDGETON, MO 63044-2510
(314) 291-7510
(314) 291-0001
Taxonomy
Speciality
Code
Description
License number
State
2086S0105X
Surgery of the Hand (Surgery) Physician
Primary
R9513
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7672
BLUE CROSS BLUE SHIELD
MO
Enumeration date
06/26/2006
Last updated
01/31/2008
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