Gardner, Glendon M.

Gardner, Glendon M. is an individual health care provider with primary practice located at 6777 W Maple Rd , West Bloomfield MI 48322-3013. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Gardner, Glendon M. can be contacted via phone (248) 661-7211.

Contact Information

Primary practice address
6777 W Maple Rd West Bloomfield MI 48322-3013
Phone: (248) 661-7211
Fax: (248) 661-6456
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 063874 Michigan

Profile Details

NPI number 1871669242
LBN Legal business name Gardner, Glendon M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Mar 10th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871669242 NPPES
Other GG063874 CHAMPUS-CHAMPUS
Other 700H262260 CHAMPUS-CHAMPUS
MEDICAID 307008110 CHAMPUS-CHAMPUS
Other GG063874 CHAMPUS-CHAMPUS

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