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General NPI Number Information
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NPI Number | 1063692648
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Entity Type | Organization
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Legal Business Name | GLASGOW INTERNAL MEDICINE ASSOCIATES PA
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2600 GLASGOW AVE SUITE 126
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City | NEWARK
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State | DE
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Zip | 19702-4773
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Country | US
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Telephone | 302-836-0100
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Fax | 302-836-5244
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Provider Business Mailing Address
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Address Line | 2600 GLASGOW AVE SUITE 126
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City | NEWARK
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State | DE
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Zip | 19702-4773
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Country | US
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Telephone | 302-836-0100
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Fax | 302-836-5244
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Authorized Official
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Title or Position | PRESIDENT
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Name | CURT DANIEL BLACKLOCK
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Credential | DO
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Telephone | 302-836-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C20003134
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License Number State | DE
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