Provider Demographics
NPI:1053985523
Name:GLERUM, ANDREW LAWRENCE (DO)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:LAWRENCE
Last Name:GLERUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4344 WOODLANDS BLVD STE 260
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2801
Mailing Address - Country:US
Mailing Address - Phone:303-649-3155
Mailing Address - Fax:303-649-3156
Practice Address - Street 1:4344 WOODLANDS BLVD STE 260
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2801
Practice Address - Country:US
Practice Address - Phone:303-649-3155
Practice Address - Fax:303-649-3156
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.69263207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine