Provider Demographics
NPI:1336315027
Name:LAWRENCE J ZGLINIEC MD PC
Entity Type:Organization
Organization Name:LAWRENCE J ZGLINIEC MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ZGLINIEC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-334-9691
Mailing Address - Street 1:44555 WOODWARD AVE
Mailing Address - Street 2:SUITE 505
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-5031
Mailing Address - Country:US
Mailing Address - Phone:248-334-9691
Mailing Address - Fax:248-858-3885
Practice Address - Street 1:44555 WOODWARD AVE
Practice Address - Street 2:SUITE 505
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5031
Practice Address - Country:US
Practice Address - Phone:248-334-9691
Practice Address - Fax:248-858-3885
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAWRENCE J ZGLINIEC MD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI028744207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
061045035OtherRR MEDICARE
B43166OtherHAP
0633394OtherBCN
103961OtherPREFERRED CHOICES
C5910OtherM CARE
103961OtherCARE CHOICE
0633394OtherBLUE CROSS
4132044OtherAARP
103961OtherPREFERRED CHOICES