Provider Demographics
NPI:1558321992
Name:GLOS, WILLIAM HARVEY (CST/CFA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:HARVEY
Last Name:GLOS
Suffix:
Gender:M
Credentials:CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4868 WYANDOT ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-1368
Mailing Address - Country:US
Mailing Address - Phone:303-455-8812
Mailing Address - Fax:303-480-1109
Practice Address - Street 1:4868 WYANDOT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80221-1368
Practice Address - Country:US
Practice Address - Phone:303-455-8812
Practice Address - Fax:303-480-1109
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCERTIFICATION 90771246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist