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NPI Code Detail

MEDICARE: DR. IRA PAUL GLOVINSKY PH.D.

MEDICARE:  DR. IRA PAUL GLOVINSKY  PH.D.
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
1103T00000XPsychologist6301002575MI

General Provider Information

NPI Number : 1801925144
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRA PAUL GLOVINSKY PH.D.
Provider Business Mailing Address
First Line : 2001 PAULINE CT
Second Line :
City : ANN ARBOR
State : MI
Zip : 48103-5185
Country : US
Telephone Number : 734-741-1532
Fax Number : 248-538-1558
Provider Business Practice Location Address
First Line : 6022 W MAPLE RD
Second Line : 408
City : WEST BLOOMFIELD
State : MI
Zip : 48322-4408
Country : US
Telephone Number : 248-538-9070
Fax Number : 248-538-1558
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2007
Last Update Date : 07/08/2007

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Directions to “ DR. IRA PAUL GLOVINSKY PH.D.” Practice Location

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