MEDICARE: ALAN DANIEL GLASSMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	35054446	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2520462	OTHER		UNITED
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0646138	OTHER		AETNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000238164	OTHER		ANTHEM WILIMINGTON
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	000000279060	OTHER	IN	ANTHEM DEARBORN
9	000000019843	OTHER		ANTHEM HAMILTON
10	311438871053	OTHER		CARESOURCE
11	283816	OTHER		AMERIGROUP
12	54446	OTHER		HUMANA CHOICECARE

General Provider Information

NPI Number	:	1316914237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN DANIEL GLASSMAN M.D.

Provider Business Mailing Address
First Line	:	237 WILLIAM HOWARD TAFT RD
Second Line	:	2ND FLOOR, CBO 2-3
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2610
Country	:	US
Telephone Number	:	513-206-1800
Fax Number	:	513-208-1834

Provider Business Practice Location Address
First Line	:	5885 HARRISON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-1691
Country	:	US
Telephone Number	:	513-206-1800
Fax Number	:	513-206-1834

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	10/21/2020

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