Provider Demographics
NPI:1790733798
Name:GLASS, LOUIS L (MD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:L
Last Name:GLASS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:785 5TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:120 N 7TH ST STE 200
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1795
Practice Address - Country:US
Practice Address - Phone:717-217-6803
Practice Address - Fax:717-217-6824
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2020-06-05
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Provider Licenses
StateLicense IDTaxonomies
PAMD060813L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016338130002Medicaid
PA0016338130002Medicaid
PA829896LN7Medicare PIN