MEDICARE: DR. PAUL R. GLASER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	116	NC
2	213E00000X	Podiatrist	2480	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0802R	OTHER	NC	BLUECROSS/BLUESHIELD
3	23656	OTHER	NC	MEDCOST
4	1659398	OTHER	NC	OXFORD HEALTH UHC
5	2728879	OTHER	NC	UNITED HEALTHCARE
6	P02480-31	OTHER	NY	NY WORKERS COMP
7	1079890001	OTHER	NC	PALMETTO DURABLE GOODS

General Provider Information

NPI Number	:	1376595801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL R. GLASER DPM

Provider Business Mailing Address
First Line	:	4113 OLEANDER DR
Second Line	:	SUITE G
City	:	WILMINGTON
State	:	NC
Zip	:	28403-6821
Country	:	US
Telephone Number	:	910-791-1300
Fax Number	:	910-791-4125

Provider Business Practice Location Address
First Line	:	4113 OLEANDER DR
Second Line	:	SUITE G
City	:	WILMINGTON
State	:	NC
Zip	:	28403-6821
Country	:	US
Telephone Number	:	910-791-1300
Fax Number	:	910-791-4125

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	02/06/2008

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