Provider Demographics
NPI:1346536299
Name:GLASER, ADAM N (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:N
Last Name:GLASER
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 1:6485 SW BORLAND RD STE B
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-9762
Mailing Address - Country:US
Mailing Address - Phone:503-272-8825
Mailing Address - Fax:503-427-9321
Practice Address - Street 1:6485 SW BORLAND RD STE B
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-9762
Practice Address - Country:US
Practice Address - Phone:503-272-8825
Practice Address - Fax:503-427-9321
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD164199207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine