Provider Demographics
NPI:1023113792
Name:GLASSINGER, MICHAEL CHRISTIAN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHRISTIAN
Last Name:GLASSINGER
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 1:5010 MANCUSO LN
Mailing Address - Street 2:APT #115
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3594
Mailing Address - Country:US
Mailing Address - Phone:337-298-8450
Mailing Address - Fax:
Practice Address - Street 1:639 LOTUS DR N
Practice Address - Street 2:SUITE B
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-2926
Practice Address - Country:US
Practice Address - Phone:985-626-6133
Practice Address - Fax:985-626-6136
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA026263207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1052515Medicaid
LAG6438OtherBCBS
LA1052515Medicaid
LA4J676CM53Medicare PIN