Provider Demographics
NPI:1275733735
Name:GLAWATZ, JEREMY DALE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:DALE
Last Name:GLAWATZ
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1026 A AVE NE
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5036
Mailing Address - Country:US
Mailing Address - Phone:319-369-7085
Mailing Address - Fax:319-368-5932
Practice Address - Street 1:1026 A AVE NE
Practice Address - Street 2:SUITE 5000
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5036
Practice Address - Country:US
Practice Address - Phone:319-369-7085
Practice Address - Fax:319-368-5932
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2011-10-13
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical