Provider Demographics
NPI:1093993420
Name:GLAZIER, ALAN N (OD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:N
Last Name:GLAZIER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15200 SHADY GROVE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3218
Mailing Address - Country:US
Mailing Address - Phone:301-670-1212
Mailing Address - Fax:301-216-9692
Practice Address - Street 1:15200 SHADY GROVE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3218
Practice Address - Country:US
Practice Address - Phone:301-670-1212
Practice Address - Fax:301-216-9692
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1210152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01480F02Medicare PIN
U62934Medicare UPIN
0626090001Medicare NSC