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Individual
MR. ERIC WALLACE GLISSMEYER
Active
Individual
MR. ERIC WALLACE GLISSMEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
7891781-1205
UT
282NC2000X
Children's Hospital
—
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/11/2008
Last updated
12/10/2021
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