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NPI Code Detail

MEDICARE: DR. CHARLES JONATHAN GLUECK MD

MEDICARE:  DR. CHARLES JONATHAN GLUECK  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RE0101XEndocrinology, Diabetes & Metabolism Physician35.027629OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275630667
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES JONATHAN GLUECK MD
Provider Business Mailing Address
First Line : 2135 DANA AVE
Second Line : SUITE 430
City : CINCINNATI
State : OH
Zip : 45207-1313
Country : US
Telephone Number : 513-924-8250
Fax Number : 513-924-8272
Provider Business Practice Location Address
First Line : 2135 DANA AVE
Second Line : SUITE 430
City : CINCINNATI
State : OH
Zip : 45207-1313
Country : US
Telephone Number : 513-924-8250
Fax Number : 513-924-8272
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 09/24/2014

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