Provider Demographics
NPI:1568575801
Name:GLASSMAN, IRWIN GARY (MD)
Entity Type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:GARY
Last Name:GLASSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8906 SPANISH RIDGE AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1319
Mailing Address - Country:US
Mailing Address - Phone:702-330-3102
Mailing Address - Fax:702-912-4994
Practice Address - Street 1:1934 E SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3842
Practice Address - Country:US
Practice Address - Phone:702-369-5758
Practice Address - Fax:702-431-1860
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2020-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV4299207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1568575801Medicaid
NV2002009Medicaid
NVC96223Medicare UPIN
NVV108012Medicare PIN