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NPI Code Detail

MEDICARE: DR. ANDREW GEORGE BERNARD GLASS MD

MEDICARE: DR. ANDREW GEORGE BERNARD GLASS MD
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
1207P00000XEmergency Medicine Physician0000070345TN

General Provider Information

NPI Number : 1689342958
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW GEORGE BERNARD GLASS MD
Provider Business Mailing Address
First Line : 743 SPRING ST
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 743 SPRING ST NE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3715
Country : US
Telephone Number : 423-778-7296
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2021
Last Update Date : 06/21/2026

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