Individual
MARIA LEE GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
313 FEDERAL DR NW, SUITE 200, CORYDON, IN 47112-3070
(812) 738-4155
(812) 738-6104
Mailing address
313 FEDERAL DR NW, SUITE 200, CORYDON, IN 47112-3070
(812) 738-4155
(812) 738-6104
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01066600A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
616162
ANTHEM
IN
Enumeration date
10/11/2007
Last updated
12/02/2020
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