Provider Demographics
NPI:1871581850
Name:GLUR, EDWIN H (OD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:H
Last Name:GLUR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 NICOLLET MALL
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-2606
Mailing Address - Country:US
Mailing Address - Phone:612-338-4861
Mailing Address - Fax:612-333-8306
Practice Address - Street 1:825 NICOLLET MALL
Practice Address - Street 2:SUITE 2000
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2606
Practice Address - Country:US
Practice Address - Phone:612-338-4861
Practice Address - Fax:612-333-8306
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1557152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2200642OtherSELECTCARE
MN83D43GLOtherBLUE SHIELD
MN200002101436OtherMETROPOLITAN HEALTH PLAN
MNHP19408OtherHEALTHPARTNERS
MN127644C757OtherUCARE FOR SENIORS
MN2200642OtherMEDICA CHOICE
MN1014011OtherPREFERRED ONE
MN127644C757OtherUCARE
MN2122690OtherMEDICA CHOICE OPTICAL
MN880823600Medicaid
MN2200642OtherMEDICA PRIMARY
MN38609400Medicaid
MNT66878OtherPATIENT CHOICE
MN880823600Medicaid
MN2200642OtherMEDICA PRIMARY
MN410043195Medicare ID - Type UnspecifiedRR MEDICARE
MN410001412Medicare ID - Type Unspecified