| Doctor Name: | DR. VADIM GLUKH |
| NPI Number: | 1164406195 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | 36003112 |
| Business Practice Address: | 35010 Chardon Rd Suite 101a Willoughby Hills, OH - 440949011 |
| Business Phone Number: | 4409533668 |
| Business Fax Number: | 4409533556 |
| Mailing Address: | 35010 Chardon Rd, Suite 101a WILLOUGHBY HILLS |
| State: | OH |
| Postal Code: | 440949011 |
| Phone Number: | 4409533668 |
| Fax Number: | 4409533556 |
| NPI Enumeration Date: | 12/02/2005 |
| NPI Last Update Date: | 04/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 36003112 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |