Provider Demographics
NPI:1487677423
Name:GLAUS, CHERI J (OD)
Entity Type:Individual
Prefix:DR
First Name:CHERI
Middle Name:J
Last Name:GLAUS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16346 COUNTY ROAD 13
Mailing Address - Street 2:
Mailing Address - City:FAIRHOPE
Mailing Address - State:AL
Mailing Address - Zip Code:36532-5307
Mailing Address - Country:US
Mailing Address - Phone:330-687-6906
Mailing Address - Fax:
Practice Address - Street 1:600 BEL AIR BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-3501
Practice Address - Country:US
Practice Address - Phone:251-476-4744
Practice Address - Fax:251-476-4741
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21389-875152W00000X
FLTPOP83152W00000X
ALR210-TA944152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0498715Medicaid
OH0584485Medicare PIN
OHT48415Medicare UPIN