Individual
JAIME M GLORIOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1100 WALNUT ST FL 5, PHILADELPHIA, PA 19107
(215) 955-6750
Mailing address
1100 WALNUT ST FL 5, PHILADELPHIA, PA 19107-4944
(215) 955-6750
(215) 923-8222
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
54114
MN
208600000X
Surgery Physician
D84078
MD
208600000X
Surgery Physician
Primary
MD468151
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
07/14/2010
Last updated
07/18/2019
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