Individual
JEFFREY GLICKSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 MERCANTILE LN, UPPER MARLBORO, MD 20774-5374
(301) 618-5500
Mailing address
1221 MERCANTILE LN, UPPER MARLBORO, MD 20774-5374
(301) 618-5500
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
D0090587
MD
390200000X
Student in an Organized Health Care Education/Training Program
63718
NY
Other
Enumeration date
04/08/2016
Last updated
08/25/2021
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