Provider Demographics
NPI:1083000178
Name:GLASS, DAVID MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:GLASS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:DAVID GLASS, MD, EMERGENCY DEPARTMENT
Mailing Address - Street 2:1100 CENTRAL AVE SE
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-0000
Mailing Address - Country:US
Mailing Address - Phone:505-841-1125
Mailing Address - Fax:505-724-6543
Practice Address - Street 1:EMERGENCY MEDICINE MSC 11 6025
Practice Address - Street 2:UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-6000
Practice Address - Fax:505-272-6503
Is Sole Proprietor?:No
Enumeration Date:2015-04-15
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMRS2015-0373390200000X
NMMD2017-0770207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program