Organization Active NPI

Stefan Glowacki M.D.,P.C.

  • Orthopaedic Surgery Physician
  • Sterling Heights, MI
National Provider Identifier
1972827244
Registry record updated Aug 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
SG040818 Issued in MI
Legal business name
STEFAN GLOWACKI M.D.,P.C.
Practice address
42370 Van Dyke Ave
Suite 107
Sterling Heights, MI 48314-3487
Phone
(586) 991-0051
Fax
(586) 991-0064
NPI assigned
Mar 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2013

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

Authorized official

Name
Dr. Stefan Glowacki, M.D.
Title
President
Phone
(586) 991-0051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X SG040818 MI Primary

Addresses

Primary practice location

42370 Van Dyke Ave
Suite 107
Sterling Heights, MI 48314-3487

Mailing address

42370 Van Dyke Ave
Suite 107
Sterling Heights, MI 48314-3487
Phone (586) 991-0051

Other identifiers 3

IdentifierTypeStateIssuer
2005071942OtherMIBCBSM
2000E03267OtherBCBSM
142048510MedicaidMI

National Provider Directory

National Provider Directory

Locations

42370 Van Dyke Ave
Ste 107
Sterling Heights, MI 48314
Phone (586) 254-1177

40600 Van Dyke Ave
Ste 1
Sterling Heights, MI 48313
Phone (586) 795-0320

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1972827244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42370 VAN DYKE AVE",
            "address_2": "SUITE 107",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143487",
            "telephone_number": "586-991-0051",
            "fax_number": "586-991-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42370 VAN DYKE AVE",
            "address_2": "SUITE 107",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143487",
            "telephone_number": "586-991-0051",
            "fax_number": "586-991-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEFAN GLOWACKI M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-16",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "GLOWACKI",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-991-0051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "SG040818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "2005071942",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "2000E03267",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142048510",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; 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.