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General NPI Number Information
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NPI Number | 1336224963
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Entity Type | Individual
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Provider Name | WOLFRAM GLASER MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1701 AVENUE D
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City | BIRMINGHAM
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State | AL
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Zip | 35218-1532
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Country | US
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Telephone | 205-788-7770
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Fax | 205-788-7552
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Provider Business Mailing Address
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Address Line | 3636 LESLIE ANN RD
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City | BIRMINGHAM
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State | AL
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Zip | 35243-4600
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Country | US
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Telephone | 205-979-0904
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 00006203
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License Number State | AL
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