MEDICARE: PAUL GLAZER, M.D., P.C.

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	207XS0117X	Orthopaedic Surgery of the Spine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700817228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL GLAZER, M.D., P.C.

Provider Business Mailing Address
First Line	:	545 HAMMOND ST
Second Line	:
City	:	CHESTNUT HILL
State	:	MA
Zip	:	02467-1703
Country	:	US
Telephone Number	:	617-232-5455
Fax Number	:	617-232-5002

Provider Business Practice Location Address
First Line	:	822 BOYLSTON ST
Second Line	:
City	:	CHESTNUT HILL
State	:	MA
Zip	:	02467-2595
Country	:	US
Telephone Number	:	617-860-6388
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PAUL A GLAZER
Credential	:	M.D.
Telephone Number	:	617-860-6388

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	11/06/2018

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