Provider Demographics
NPI:1720256837
Name:MARC S. GLOVINSKY, DPM, LLC
Entity type:Organization
Organization Name:MARC S. GLOVINSKY, DPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:GLOVINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:504-454-2900
Mailing Address - Street 1:3939 HOUMA BLVD
Mailing Address - Street 2:BLDG. 6, SUITE 224
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2931
Mailing Address - Country:US
Mailing Address - Phone:504-454-2900
Mailing Address - Fax:504-454-2915
Practice Address - Street 1:3939 HOUMA BLVD
Practice Address - Street 2:BLDG. 6, SUITE 224
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2931
Practice Address - Country:US
Practice Address - Phone:504-454-2900
Practice Address - Fax:504-454-2915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPD253R213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3879230001Medicare NSC
LAU74738Medicare UPIN
LA5E455Medicare PIN