Individual
GLENN JOSEPH KASHURBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 S CENTER AVE, SOMERSET, PA 15501-2057
(814) 445-9695
(814) 444-8812
Mailing address
113 S CENTER AVE, STE 1, SOMERSET, PA 15501-2063
(814) 445-9695
(814) 444-8812
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
D0035419
MD
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD029895E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001132194
—
PA
01
—
1397413
UMWA
—
01
—
435297
HIGHMARK
PA
Enumeration date
12/13/2006
Last updated
06/21/2016
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