Healthcare Provider Details

I. General information

NPI: 1780679688
Provider Name (Legal Business Name): ROBERT GLASSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ROBERT MICHAEL GLASSER MD

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E MARSHALL ST INTERNAL MEDICINE
RICHMOND VA
23298-5051
US

IV. Provider business mailing address

PO BOX 91734
RICHMOND VA
23291-1734
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-6938
  • Fax: 804-828-4862
Mailing address:
  • Phone: 804-358-6100
  • Fax: 804-342-7619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number0101242866
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number12282
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: