Healthcare Provider Details
I. General information
NPI: 1982223921
Provider Name (Legal Business Name): CHRISTIAN BARRETT GLUCK MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/09/2020
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 UNIVERSITY DR
HERSHEY PA
17033-2360
US
IV. Provider business mailing address
500 UNIVERSITY DR RM C4833
HERSHEY PA
17033-2360
US
V. Phone/Fax
- Phone: 717-531-6822
- Fax:
- Phone: 717-531-8945
- Fax: 717-531-6160
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | MD490151 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: