Healthcare Provider Details

I. General information

NPI: 1255330551
Provider Name (Legal Business Name): MARC STEVEN GLOVINSKY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 HOUMA BLVD BLDG. 6, SUITE 224
METAIRIE LA
70006-2931
US

IV. Provider business mailing address

3939 HOUMA BLVD BLDG. 6, SUITE 224
METAIRIE LA
70006-2931
US

V. Phone/Fax

Practice location:
  • Phone: 504-454-2900
  • Fax: 504-454-2915
Mailing address:
  • Phone: 504-454-2900
  • Fax: 504-454-2915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPD253R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: