Provider Demographics
NPI:1649238452
Name:GLYMAN, STEVEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:GLYMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 W CHARLESTON BLVD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2325
Mailing Address - Country:US
Mailing Address - Phone:702-671-2355
Mailing Address - Fax:702-382-5388
Practice Address - Street 1:880 SEVEN HILLS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4371
Practice Address - Country:US
Practice Address - Phone:702-731-9110
Practice Address - Fax:702-614-8356
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV55192084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVWQBHVOtherMEDICARE
13WCHCM01Medicare ID - Type Unspecified
C96083Medicare UPIN