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General NPI Number Information
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NPI Number | 1104145853
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Entity Type | Organization
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Legal Business Name | STEPHEN R. GLASER M.D. P.C.
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 05/20/2010
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Provider Practice Location Address
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Address Line | 15235 SHADY GROVE RD STE 101
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City | ROCKVILLE
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State | MD
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Zip | 20850-6273
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Country | US
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Telephone | 301-330-1366
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Fax |
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Provider Business Mailing Address
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Address Line | 15235 SHADY GROVE RD STE 101
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City | ROCKVILLE
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State | MD
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Zip | 20850-6273
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN R GLASER
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Credential |
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Telephone | 301-330-1366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | D0051706
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License Number State | MD
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