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General NPI Number Information
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NPI Number | 1265514731
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Entity Type | Individual
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Provider Name | GLENN ROBERT MEINTS DPM
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Gender | Male
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 324 W SUPERIOR ST STE 517
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City | DULUTH
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State | MN
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Zip | 55802-1760
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Country | US
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Telephone | 218-722-0326
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Fax | 218-722-4403
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Provider Business Mailing Address
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Address Line | 2107 E 4TH ST
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City | DULUTH
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State | MN
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Zip | 55812-1427
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Country | US
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Telephone | 218-724-9581
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 532
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License Number State | MN
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