Provider Demographics
NPI:1881695963
Name:GLOSSER, DAVID SAUL (SCD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SAUL
Last Name:GLOSSER
Suffix:
Gender:M
Credentials:SCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 W TILGHMAN ST
Mailing Address - Street 2:COMMERCE CORPORATE CENTER STE 125
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9109
Mailing Address - Country:US
Mailing Address - Phone:610-821-9740
Mailing Address - Fax:610-395-0019
Practice Address - Street 1:5000 W TILGHMAN ST
Practice Address - Street 2:COMMERCE CORPORATE CENTER STE 125
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9109
Practice Address - Country:US
Practice Address - Phone:610-821-9740
Practice Address - Fax:610-395-0019
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005261L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01715501OtherCAPITAL BLUE CROSS
PA700569Medicare PIN