Provider Demographics
NPI:1366447955
Name:GLASS, CONSTANCE LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:LYNN
Last Name:GLASS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:13250 HAZEL DELL PKWY
Mailing Address - Street 2:STE 103
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8527
Mailing Address - Country:US
Mailing Address - Phone:317-843-9475
Mailing Address - Fax:317-843-9476
Practice Address - Street 1:13250 HAZEL DELL PKWY
Practice Address - Street 2:STE 103
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-8527
Practice Address - Country:US
Practice Address - Phone:317-843-9475
Practice Address - Fax:317-843-9476
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01045216A173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine