MEDICARE: DAVID GLEITZMAN D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	00141	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164507935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID GLEITZMAN D.P.M.

Provider Business Mailing Address
First Line	:	2000 HAMPTON CTR
Second Line	:	#B
City	:	MORGANTOWN
State	:	WV
Zip	:	26505-1704
Country	:	US
Telephone Number	:	304-599-9000
Fax Number	:	304-599-4091

Provider Business Practice Location Address
First Line	:	2000 HAMPTON CTR
Second Line	:	#B
City	:	MORGANTOWN
State	:	WV
Zip	:	26505-1704
Country	:	US
Telephone Number	:	304-599-9000
Fax Number	:	304-599-4091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	10/05/2007

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