Provider Demographics
NPI:1255332482
Name:GLASSER, RICHARD HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HENRY
Last Name:GLASSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7043 E MONTANA PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2247
Mailing Address - Country:US
Mailing Address - Phone:303-753-9344
Mailing Address - Fax:720-981-7477
Practice Address - Street 1:8340 S SANGRE DE CRISTO RD
Practice Address - Street 2:105
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-4248
Practice Address - Country:US
Practice Address - Phone:303-932-2111
Practice Address - Fax:720-981-7477
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO20355207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20355OtherLICENSE
E22403Medicare UPIN
418528Medicare ID - Type Unspecified