Provider Demographics
NPI:1003828849
Name:GLORIOSO, JOSEPH JUDE (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JUDE
Last Name:GLORIOSO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PLAZA DR STE G
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-7729
Mailing Address - Country:US
Mailing Address - Phone:304-650-5027
Mailing Address - Fax:740-699-0271
Practice Address - Street 1:103 PLAZA DR STE G
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-7729
Practice Address - Country:US
Practice Address - Phone:304-650-5027
Practice Address - Fax:740-699-0271
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006863207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0055393000Medicaid
OH2077845Medicaid
P00141754OtherRAILROAD MEDICARE
P00141754OtherRAILROAD MEDICARE
WV0055393000Medicaid