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Individual

MARK STUART GLASER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-4372
(910) 321-6232
Mailing address
524 BEAUMONT RD, FAYETTEVILLE, NC 28304-4443
(910) 615-4372
(910) 321-6232

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
22727
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
194636
MEDCOST, DOCTORS DIRECT
NC
01
35746
BCBS OF NC
NC
05
8935746
NC
01
P00389963
RAILROAD MEDICARE
NC
Enumeration date
07/11/2006
Last updated
11/20/2015
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