Individual
DR. JOHN BREWER GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7066 STILLWATER BLVD N, OAKDALE, MN 55128-3937
(651) 777-5222
(651) 251-5111
Mailing address
7066 STILLWATER BLVD N, OAKDALE, MN 55128-3937
(651) 777-5222
(651) 251-5111
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
35198
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423062100
—
MN
Enumeration date
06/28/2006
Last updated
08/14/2012
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