Individual
MICHELLE SARAH GLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CTR DR, ANN ARBOR, MI 48109-5718
(734) 647-1774
Mailing address
1500 EAST MEDICAL CTR DR, MPB D3230 SPC 5718, ANN ARBOR, MI 48109-5718
(734) 647-1774
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4351045103
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4351045103
LIMITED EDUC LICENSES
MI
01
—
5315207207
CONTROLLED SUBSTANCE LICENSE
MI
Enumeration date
06/14/2019
Last updated
06/14/2019
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