Individual
DR. DAVID GLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
175 N OAKS PLZ, SAINT LOUIS, MO 63121-2925
(314) 391-9777
(314) 390-5404
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
(314) 391-9777
(314) 390-5404
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
112861
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047010581
CPIN
MO
05
—
20497110
—
MO
05
—
204977102
—
MO
Enumeration date
11/30/2005
Last updated
10/21/2021
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