Provider Demographics
NPI:1609866466
Name:GLASSMAN, ROLAND MILES (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:MILES
Last Name:GLASSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:407 RIVERWAY PL
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6765
Mailing Address - Country:US
Mailing Address - Phone:603-668-3772
Mailing Address - Fax:603-668-2786
Practice Address - Street 1:407 RIVERWAY PL
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6765
Practice Address - Country:US
Practice Address - Phone:603-668-3772
Practice Address - Fax:603-668-2786
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH6670207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2350979OtherCIGNA
NH100481YONH01OtherANTHEM
NH82180481Medicaid
NH100481YONH01OtherANTHEM
NH2350979OtherCIGNA