Provider Demographics
NPI:1386840361
Name:GLASSMAN, SETH ROBERT (SETH GLASSMAN MD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:ROBERT
Last Name:GLASSMAN
Suffix:
Gender:M
Credentials:SETH GLASSMAN MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8390 CHAMPIONS GATE BLVD STE 215
Mailing Address - Street 2:
Mailing Address - City:CHAMPIONS GATE
Mailing Address - State:FL
Mailing Address - Zip Code:33896-8310
Mailing Address - Country:US
Mailing Address - Phone:407-390-1677
Mailing Address - Fax:407-390-1765
Practice Address - Street 1:ELM AND CARLTON STREETS
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:716-845-8518
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60457118207R00000X
CAC155559207R00000X
390200000X
NY297299207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program