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General NPI Number Information
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NPI Number | 1285428565
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Entity Type | Organization
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Legal Business Name | GLIMMER MEDICAL GROUP, P.D.
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 6375 PENN AVE STE B1135
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City | PITTSBURGH
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State | PA
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Zip | 15206-4010
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Country | US
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Telephone | 917-439-7134
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Fax |
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Provider Business Mailing Address
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Address Line | 6375 PENN AVE STE B1135
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City | PITTSBURGH
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State | PA
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Zip | 15206-4010
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Country | US
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Telephone | 917-439-7134
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL EDNIE
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Credential | MD
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Telephone | 203-517-8101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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