Provider Demographics
NPI:1407911936
Name:GLASSMAN, VICTOR PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:PHILIP
Last Name:GLASSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:V.
Other - Middle Name:PHILIP
Other - Last Name:GLASSMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4760 E GALBRAITH RD STE 203
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6704
Mailing Address - Country:US
Mailing Address - Phone:513-985-9800
Mailing Address - Fax:513-985-9833
Practice Address - Street 1:4760 E GALBRAITH RD
Practice Address - Street 2:#203
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6703
Practice Address - Country:US
Practice Address - Phone:513-985-9800
Practice Address - Fax:513-985-9833
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-03-1789-G207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0328078Medicaid
0411373Medicare Oscar/Certification
OHC01205Medicare UPIN
700007965Medicare Oscar/Certification