Individual provider · NPI-1

Glendon M. Gardner, M.D.

Otolaryngology · West Bloomfield, MI

NPI number1871669242
StatusActive
Last updated in NPPESMar 10, 2021

Details

NPI
1871669242
Entity type
Individual (NPI-1)
Name
Glendon M. Gardner
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Nov 28, 2006
Certification date
Mar 10, 2021
Last updated
Mar 10, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Y00000X Otolaryngology063874MIYes

Practice location

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Phone 248-661-7211 · Fax 248-661-6456

Mailing address

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Phone 248-661-7211 · Fax 248-661-6456

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Otolaryngology providers in West Bloomfield, MI