Provider Demographics
NPI:1265496772
Name:GLUECK, ROBERT M (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:GLUECK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 843769
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3769
Mailing Address - Country:US
Mailing Address - Phone:816-941-7727
Mailing Address - Fax:816-941-7456
Practice Address - Street 1:930 CARONDELET DR
Practice Address - Street 2:SUITE 200
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4855
Practice Address - Country:US
Practice Address - Phone:816-941-7727
Practice Address - Fax:816-941-7456
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR2C58207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO060016103OtherRAILROAD MEDICARE
MO11507040OtherBCBS-KC
MO1265496772Medicaid
MOE08054Medicare UPIN
MO1265496772Medicaid
MOB755401Medicare ID - Type Unspecified