MICHAEL GLOCK (NPI# 1033194006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033194006 |
| Entity Type | Individual |
| Full Name | MICHAEL GLOCK |
| Credential | MD |
| Practice Address |
Medical Center Blvd Winston Salem NC 27157-0001 |
| Mailing Address |
Po Box 344 Winston Salem NC 27102-0344 |
| Practice Telephone | 3367162255 |
| Mailing Telephone | 3367162255 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2008-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
35903 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 4525084 | 01 | |
| WV | 215713000 | 05 | |
| PARTNERS | 2794 | 01 | |
| MEDCOST | 44931 | 01 | |
| NC | 8935991 | 05 | |
| SC | Q35903 | 05 | |
| BCBS | 35991 | 01 | |
| VA | 6710026 | 05 |
| Street Address |
MEDICAL CENTER BLVD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27157-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811990815 | Gary Lee Ray | Registered Nurse | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-05-23 |
| 1881295418 | Alan Townes Grizzard | Nurse Practitioner | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-11-02 |
| 1003421751 | Nicholas Ryan Tuttle | Nurse Anesthetist, Certified Registered | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-09-10 |
| 1356956122 | Caitlin Marie Clement | Nurse Anesthetist, Certified Registered | Medical Center Blvd, Winston Salem, NC 27103 | 2020-09-09 |
| 1376154591 | Lori Sansone Flores | Nurse Practitioner | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-08-11 |
| 1821609330 | Hannah Carey Walker | Physician Assistant | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-08-10 |
| 1447876883 | Raveena Mahesh Chhabria | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-06-22 |
| 1780205930 | Jason Chin | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-1087 | 2020-04-29 |
| 1972122885 | Bryanna Dean Vesely | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-04-10 |
| 1679102909 | Ameen Barghi | Student in an Organized Health Care Education/Training Program | Medical Center Blvd, Winston Salem, NC 27157-2803 | 2020-04-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255960241 | Alexandra Marie Balmaceda | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center Pathology Dept, #1 Medical Center Blvd., Winston-salem, NC 27157 | 2020-04-02 |
| 1164916680 | Jorie Elizabeth Gatts | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Department of Pediatrics, Winston Salem, NC 27157 | 2018-06-18 |
| 1932606555 | Alexi Rae Ellington Webb | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine, Dept of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 | 2018-04-10 |
| 1851896674 | Wasim Muhammad | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Psychiatry, Medical Center Blvd, Winston Salem, NC 27157 | 2018-03-25 |
| 1336643535 | Phillip Martin Kostelic | Student in an Organized Health Care Education/Training Program | Anesthesiology - Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-salem, NC 27157 | 2018-03-21 |
| 1831693324 | Aleah Bond | Student in an Organized Health Care Education/Training Program | Anesthesiology Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-salem, NC 27157 | 2018-03-20 |
| 1134644859 | Ilan Binyamin Klein | Urology | Wake Forest Baptist Health, Department of Urology, Medical Center Boulevard, Winston-salem, NC 27157 | 2017-08-03 |
| 1023467529 | Edward John Doyle IIi | Student in an Organized Health Care Education/Training Program | Wake Forest School of Medicine Dept. of Otolaryngology, Watlington Hall 4th Fl. Medical Center Boulevard, Winston-salem, NC 27157 | 2016-06-07 |
| 1477917888 | Jordan Mae Burner | Student in an Organized Health Care Education/Training Program | Graduate Medical Education Office, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-salem, NC 27157 | 2016-04-12 |
| 1174900476 | Kate Elise Winterbottom | Speech-Language Pathologist | 4 Janeway Medical Center Blvd, Hearing and Speech, Winston Salem, NC 27157 | 2015-05-06 |
| Find all providers in zip 27157 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205351756 | Dara Adina Seelig | Pediatrics | Brenner Children's Hospital Wake Forest Baptist Health, Winston Salem, NC 27157-0001 | 2017-08-06 |
| 1043331044 | Anca M Safta | Pediatrics | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2007-04-03 |
| 1558345280 | Pamela C Goodman | Pediatrics | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-12-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841760238 | Mission Community Anesthesiology Specialists LLC | Pediatrics | 2695 Hendersonville Rd Ste 206, Arden, NC 28704-8576 | 2018-11-28 |
| 1609229947 | Prathipa Santhanam | Pediatrics | N.c. Children's Hospital, 101 Manning Drive, Chapel Hill, NC 27514 | 2016-07-21 |
| 1912286410 | Carolinas Medical Center-northeast | Pediatrics | 101 East W T Harris Blvd, Bldg 3000, Suite 3301e, Charlotte, NC 28262-7000 | 2011-08-15 |
| 1013296730 | Timothy Menz | Pediatrics | 2711 Randolph Rd Ste 301, Charlotte, NC 28207-2027 | 2011-08-11 |
| 1396904967 | Sachin Shrikar Kunde | Pediatrics | 2601 Lake Dr Ste 201, Raleigh, NC 27607-6689 | 2008-06-08 |
| 1639260243 | Rose Corinne Marcus | Pediatrics | 333 South Columbia Street Cb 7229, Chapel Hill, NC 27599-4202 | 2006-09-27 |
| 1336704766 | Wakemed Specialists Group, LLC | Pediatrics | 23 Sunnybrook Rd, Raleigh, NC 27610-1855 | 2019-05-01 |
| 1982105375 | Pedzfeedz, Pllc | Pediatrics | 720 Saint James Dr, Wilmington, NC 28403 | 2018-02-22 |
| 1013453604 | Novant Medical Group, Inc. | Pediatrics | 11840 Southmore Dr, Suite 200, Charlotte, NC 28277-4466 | 2017-01-06 |
| 1083001465 | Erica June Brenner | Pediatrics | 101 Manning Dr, Chapel Hill, NC 27514-4220 | 2015-04-23 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON SALEM |
| Zip Code | 27157 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.