Provider Demographics
NPI:1033388673
Name:DONALD J GLAZER
Entity Type:Organization
Organization Name:DONALD J GLAZER
Other - Org Name:COMPREHENSIVE FOOT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PODIATRIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:GLAZER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:804-741-2889
Mailing Address - Street 1:7702 E PARHAM RD
Mailing Address - Street 2:SUITE 318
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4371
Mailing Address - Country:US
Mailing Address - Phone:804-741-2889
Mailing Address - Fax:804-750-1546
Practice Address - Street 1:7702 E PARHAM RD
Practice Address - Street 2:SUITE 318
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4371
Practice Address - Country:US
Practice Address - Phone:804-741-2889
Practice Address - Fax:804-750-1546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-28
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000433213ES0103X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9332243Medicaid
VA9332243Medicaid
VA480012573Medicare PIN
VA480000328Medicare PIN
VA0733810001Medicare NSC