Provider Demographics
NPI:1598817264
Name:GLANZER & NELSON PC
Entity Type:Organization
Organization Name:GLANZER & NELSON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:319-365-8616
Mailing Address - Street 1:411 10TH ST SE
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2467
Mailing Address - Country:US
Mailing Address - Phone:319-365-8616
Mailing Address - Fax:319-297-7377
Practice Address - Street 1:411 10TH ST SE
Practice Address - Street 2:SUITE 1400
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2467
Practice Address - Country:US
Practice Address - Phone:319-365-8616
Practice Address - Fax:319-297-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA70009Medicare PIN