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GLENN WILLIAM POTTMEYER DO NPI 1417452475


NPI Information

NPI: 1417452475
Provider Name: GLENN WILLIAM POTTMEYER, DO
Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3601 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073
Phone: (248) 551-6489
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Glenn William Pottmeyer, DO is a student in an organized health care education training program in Royal Oak, MI. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Glenn William Pottmeyer, DO NPI is 1417452475. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3601 W 13 MILE RD
ROYAL OAK, MI
ZIP 48073-712
Phone: (248) 551-6489

The NPI 1417452475 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/29/2018 and was last updated on 6/26/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0200XInternal MedicineCritical Care Medicine5101026112MICHIGANNo
2207RP1001XInternal MedicinePulmonary Disease5101026112MICHIGANNo
3390200000XStudent in an Organized Health Care Education/Training Program5101026112MICHIGANYes
4390200000XStudent in an Organized Health Care Education/Training ProgramNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.