Provider Demographics
NPI:1245337492
Name:GLASER, STEPHEN ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ROSS
Last Name:GLASER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15235 SHADY GROVE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6273
Mailing Address - Country:US
Mailing Address - Phone:301-330-1366
Mailing Address - Fax:301-987-0097
Practice Address - Street 1:15235 SHADY GROVE RD STE 101
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6273
Practice Address - Country:US
Practice Address - Phone:301-330-1366
Practice Address - Fax:301-987-0097
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0051706207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG44736Medicare UPIN
MD1532Medicare ID - Type Unspecified