Provider Demographics
NPI:1518978451
Name:GLASGOW MEDICAL ASSOCIATES PA
Entity Type:Organization
Organization Name:GLASGOW MEDICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-836-0100
Mailing Address - Street 1:2600 GLASGOW AVE
Mailing Address - Street 2:SUITE #126
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-4773
Mailing Address - Country:US
Mailing Address - Phone:302-836-0100
Mailing Address - Fax:302-836-5244
Practice Address - Street 1:2600 GLASGOW AVE
Practice Address - Street 2:SUITE #126
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-4773
Practice Address - Country:US
Practice Address - Phone:302-836-0100
Practice Address - Fax:302-836-5244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE19990037681207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE610852Medicare ID - Type Unspecified