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NPI Code Detail

MEDICARE: GEORGIA GLAVAS KALTSOUNIS

MEDICARE:   GEORGIA GLAVAS KALTSOUNIS
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist5302032640MI

General Provider Information

NPI Number : 1871139881
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGIA GLAVAS KALTSOUNIS
Provider Business Mailing Address
First Line : 65 S LIVERNOIS RD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-6901
Country : US
Telephone Number : 248-652-4700
Fax Number : 248-652-1961
Provider Business Practice Location Address
First Line : 65 S LIVERNOIS RD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-6901
Country : US
Telephone Number : 248-652-4700
Fax Number : 248-652-1961
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2019
Last Update Date : 11/29/2019

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Directions to “ GEORGIA GLAVAS KALTSOUNIS ” Practice Location

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