Healthcare Provider Details

I. General information

NPI: 1659380889
Provider Name (Legal Business Name): LOUIS A GLUEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 45TH STREET
MUNSTER IN
46321-2818
US

IV. Provider business mailing address

PO BOX 3329
MUNSTER IN
46321-3329
US

V. Phone/Fax

Practice location:
  • Phone: 219-924-3300
  • Fax: 219-934-2658
Mailing address:
  • Phone: 219-934-2652
  • Fax: 219-934-2658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number01033299A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: