Individual
MR. CLINTON EARL GLASS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
51 DEAK DR, SUITE 1 FIRST FL., SMYRNA, DE 19977-1268
(302) 653-1281
(302) 653-1283
Mailing address
51 DEAK DR, SUITE 1 FIRST FL., SMYRNA, DE 19977-1268
(302) 653-1281
(302) 653-1283
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
C5-0000852
DE
363AM0700X
Medical Physician Assistant
Primary
C5-0000852
DE
Other
Enumeration date
12/01/2012
Last updated
12/01/2012
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