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Individual

DR. CHARLOTTE GLICKSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 601-9193
(410) 601-8977
Mailing address
2401 W BELVEDERE AVE, ATTN: CREDENTIALING, BALTIMORE, MD 21215-5216
(410) 601-5524
(410) 601-8946

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D47128
MD
2080P0202X
Pediatric Cardiology Physician
D47128
MD
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
D47128
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
370007799
R/R MEDICARE PROVIDER #
MD
05
784400000
MD
Enumeration date
05/10/2006
Last updated
11/28/2007
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