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NPI Code Detail

MEDICARE: SANDRA MARIE GLAGOLA DO

MEDICARE: SANDRA MARIE GLAGOLA DO
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
1207R00000XInternal Medicine Physician58001904OH

General Provider Information

NPI Number : 1245447101
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA MARIE GLAGOLA DO
Provider Business Mailing Address
First Line : 1289 CHASE AVE
Second Line :
City : LAKEWOOD
State : OH
Zip : 44107-2601
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2500 METROHEALTH DR
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1900
Country : US
Telephone Number : 216-778-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 07/08/2007

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Directions to “ SANDRA MARIE GLAGOLA DO” Practice Location

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