Provider Demographics
NPI:1467748632
Name:GLASS, CHARLES ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ADAM
Last Name:GLASS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:100 BRICK RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2146
Mailing Address - Country:US
Mailing Address - Phone:856-983-1400
Mailing Address - Fax:856-983-1681
Practice Address - Street 1:100 BRICK RD
Practice Address - Street 2:SUITE 115
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2146
Practice Address - Country:US
Practice Address - Phone:856-983-1400
Practice Address - Fax:856-983-1681
Is Sole Proprietor?:No
Enumeration Date:2011-06-25
Last Update Date:2015-06-15
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09697000207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology