Provider Demographics
NPI:1710436704
Name:MCGLUMPHY, EDWIN A (HIS)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:A
Last Name:MCGLUMPHY
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:CANAL FULTON
Mailing Address - State:OH
Mailing Address - Zip Code:44614-0553
Mailing Address - Country:US
Mailing Address - Phone:330-826-1222
Mailing Address - Fax:
Practice Address - Street 1:6694 AKRON AVE NW
Practice Address - Street 2:
Practice Address - City:CANAL FULTON
Practice Address - State:OH
Practice Address - Zip Code:44614-9417
Practice Address - Country:US
Practice Address - Phone:330-826-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-02
Last Update Date:2016-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02968237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist