Individual
CATHY LISA GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
309 PAGE AVE, JACKSON, MI 49201-2419
(517) 205-1234
Mailing address
309 PAGE AVE, JACKSON, MI 49201-2419
(517) 205-1234
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
4301043978
MI
207RC0000X
Cardiovascular Disease Physician
043978
MI
207RC0000X
Cardiovascular Disease Physician
102978
WI
207RC0000X
Cardiovascular Disease Physician
Primary
4301043978
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100375894
—
WI
Enumeration date
03/08/2006
Last updated
09/30/2025
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