Provider Demographics
NPI:1336110303
Name:GLUCKMAN, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:GLUCKMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HOT METAL ST
Mailing Address - Street 2:QUANTUM ONE, N431
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15203-2348
Mailing Address - Country:US
Mailing Address - Phone:412-432-5806
Mailing Address - Fax:412-432-7691
Practice Address - Street 1:9930 GRUBBS RD
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9643
Practice Address - Country:US
Practice Address - Phone:412-367-1199
Practice Address - Fax:412-367-0216
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025529E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA403570OtherHIGHMARK BS
PA0010835630006Medicaid
PA10765082OtherCAQH
OH2653801Medicaid
PA403570OtherHIGHMARK BS
PA10765082OtherCAQH
PA403570F6VMedicare PIN