Individual
GLEN ENZENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
700 GERMAN ST, TAWAS CITY, MI 48763-9349
(989) 362-4170
(989) 362-0034
Mailing address
700 GERMAN ST, TAWAS CITY, MI 48763-9349
(989) 362-4170
(989) 362-0034
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101010568
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2862721
—
MI
Enumeration date
10/06/2005
Last updated
04/06/2021
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