| Doctor Name: | GLEN SHURTZ |
| NPI Number: | 1558339317 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 04-19424 |
| Business Practice Address: | 500 S Main St Wichita, KS - 672023722 |
| Business Phone Number: | 3162621103 |
| Business Fax Number: | |
| Mailing Address: | Po Box 2854, WICHITA |
| State: | KS |
| Postal Code: | 672012854 |
| Phone Number: | 3166853698 |
| Fax Number: | |
| NPI Enumeration Date: | 03/09/2006 |
| NPI Last Update Date: | 05/07/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 04-19424 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |