Provider Demographics
NPI:1013913961
Name:MAURER, GLENDA M (MD)
Entity Type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:M
Last Name:MAURER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N NORTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:KS
Mailing Address - Zip Code:67654-1449
Mailing Address - Country:US
Mailing Address - Phone:785-877-3351
Mailing Address - Fax:785-877-3646
Practice Address - Street 1:711 N NORTON AVE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:KS
Practice Address - Zip Code:67654-1449
Practice Address - Country:US
Practice Address - Phone:785-877-3351
Practice Address - Fax:785-877-3646
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0426800207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS051920OtherBLUE CROSS BLUE SHIELD
629690OtherFIRST GUARD
051920Medicare ID - Type Unspecified
KS051920OtherBLUE CROSS BLUE SHIELD