Glennan Medical Group PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301051927 Issued in MI

Legal business name

GLENNAN MEDICAL GROUP PC

Practice address

72 S Washington St
Suite 204
Oxford, MI 48371-6421

Phone

(248) 628-2233

Fax

(248) 628-2384

NPI assigned

Jul 12, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sheryl Wissman, MD

Title

Owner/Physician

Phone

(248) 628-2233

Specialties & licenses 1

Addresses

Other identifiers 10

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kelly A Fontana, MD

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1518965292
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1285632364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 S WASHINGTON ST",
            "address_2": "SUITE 204",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483716421",
            "telephone_number": "248-628-2233",
            "fax_number": "248-628-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 S WASHINGTON ST",
            "address_2": "SUITE 204",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483716421",
            "telephone_number": "248-628-2233",
            "fax_number": "248-628-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENNAN MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "WISSMAN",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "248-628-2233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301051927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICES",
            "identifier": "125218",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7023567",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CF9338",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "I17832",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "110F302700",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4266551",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "E49479",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ADVANTAGE",
            "identifier": "1011749",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4603282",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4406452",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Joseph Garr, MPT
• Gregory Michael Garvin, M.D.
• Sophia Gaves
• Andrea J Geralds
• Sarah Elizabeth Giroux, PT
• Glio Counseling Group
• James Goodrich, LLBSW
• Gregory John Gossick, D. D. S.
• Edward R. Grabenstein, D.C.
• Stacey Grandmason

• Internal Medicine Physician in Oxford, MI
• Providers in Oxford, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.