Healthcare Provider Details

I. General information

NPI: 1427011329
Provider Name (Legal Business Name): DAVID B GLAZIER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 STONY POINT DR
RICHMOND VA
23235
US

IV. Provider business mailing address

9101 STONY POINT DR
RICHMOND VA
23235
US

V. Phone/Fax

Practice location:
  • Phone: 804-330-9105
  • Fax: 804-287-6119
Mailing address:
  • Phone: 804-330-9105
  • Fax: 804-287-6119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number0101 230673
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number0101 230673
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: