Individual
MARK GLAUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 STARLING ST, SUITE 201, BRUNSWICK, GA 31520-4265
(912) 265-5125
Mailing address
2500 STARLING ST, SUITE 201, BRUNSWICK, GA 31520-4265
(912) 265-5125
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002782
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003132355A
—
GA
Enumeration date
05/21/2007
Last updated
08/22/2013
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