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Organization
SUMMIT PODIATRY INC
Active
Organization
SUMMIT PODIATRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL R GLASER DPM (DPM OWNER)
(910) 791-1300
Entity
Organization
Contact information
Practice address
4113 OLEANDER DR, SUITE G, WILMINGTON, NC 28403-6839
(910) 791-1300
(791) 791-4125
Mailing address
4113 OLEANDER DR, SUITE G, WILMINGTON, NC 28403-6839
(910) 791-1300
(910) 791-4125
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
116
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004264925
AETNA
NC
01
—
0071418-99
GHI
NY
01
—
0802R
BLUE CROSS BLUE SHIELD
NC
01
—
1659398
OXFORD HEALTH UHC
NC
01
—
23656
MEDCOST
NC
01
—
2728879
UNITED HEALTHCARE
NC
01
—
480922078
RAILROAD MEDICARE
NC
05
—
890802R
—
NC
01
—
P02480-31
NY WORKERS COMP
NY
Enumeration date
03/22/2007
Last updated
09/27/2010
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