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Individual

JOHN P. GLAZER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
123 ANDOVER RD, WESTBROOK, ME 04092-3848
(207) 761-2200
(207) 761-2108
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
(207) 661-6654
(207) 842-7773

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
35043231G
OH
2084P0800X
Psychiatry Physician
Primary
MD19711
ME
2084P0800X
Psychiatry Physician
TD121062
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0397315
OH
Enumeration date
05/03/2006
Last updated
06/22/2016
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