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General NPI Number Information
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NPI Number | 1578522207
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Entity Type | Individual
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Provider Name | ANTHONY NICHOLAS GLASER MD PHD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | 5401 NETHERBY LANE SUITE 101
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City | NORTH CHARLESTON
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State | SC
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Zip | 29420
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Country | US
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Telephone | 843-408-0092
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Fax | 843-216-0932
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Provider Business Mailing Address
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Address Line | 917 HOUSTON NORTHCUTT BLVD
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City | MT PLEASANT
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State | SC
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Zip | 29464
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Country | US
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Telephone | 843-408-0092
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Fax | 893-216-0932
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20323
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License Number State | SC
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