Healthcare Provider Details

I. General information

NPI: 1124588850
Provider Name (Legal Business Name): GEORGINA GLOGOVAC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 S WOODS MILL RD STE 330
CHESTERFIELD MO
63017-3513
US

IV. Provider business mailing address

231 ALBERT SABIN WAY PO BOX 670212
CINCINNATI OH
45267-0001
US

V. Phone/Fax

Practice location:
  • Phone: 314-576-7013
  • Fax: 314-590-5965
Mailing address:
  • Phone: 513-558-4592
  • Fax: 513-558-2220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number2025032838
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: