MEDICARE: DR. EDWIN H GLUR OD

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	152W00000X	Optometrist	1557	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2200642	OTHER	MN	SELECTCARE
2	83D43GL	OTHER	MN	BLUE SHIELD
3	200002101436	OTHER	MN	METROPOLITAN HEALTH PLAN
4	HP19408	OTHER	MN	HEALTHPARTNERS
5	127644C757	OTHER	MN	UCARE FOR SENIORS
6	2200642	OTHER	MN	MEDICA CHOICE
7	1014011	OTHER	MN	PREFERRED ONE
8	127644C757	OTHER	MN	UCARE
9	2122690	OTHER	MN	MEDICA CHOICE OPTICAL
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	2200642	OTHER	MN	MEDICA PRIMARY
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	T66878	OTHER	MN	PATIENT CHOICE

General Provider Information

NPI Number	:	1871581850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWIN H GLUR OD

Provider Business Mailing Address
First Line	:	825 NICOLLET MALL
Second Line	:	SUITE 2000
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55402-2606
Country	:	US
Telephone Number	:	612-338-4861
Fax Number	:	612-333-8306

Provider Business Practice Location Address
First Line	:	825 NICOLLET MALL
Second Line	:	SUITE 2000
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55402-2606
Country	:	US
Telephone Number	:	612-338-4861
Fax Number	:	612-333-8306

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	06/30/2010

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Directions to “ DR. EDWIN H GLUR OD” Practice Location

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