Individual
DR. JUSTIN TODD GLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10777 SUNSET OFFICE DR, SUITE 200, SAINT LOUIS, MO 63127-1019
(314) 842-4802
(314) 849-8721
Mailing address
10777 SUNSET OFFICE DR, SUITE 200, SAINT LOUIS, MO 63127-1019
(314) 842-4802
(314) 849-8721
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2001005040
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07001294
UNITED HEALTHCARE
MO
01
—
162938
BLUE CROSS BLUE SHIELD
MO
05
—
205838501
—
MO
01
—
242135
GROUP HEALTH PLAN
MO
01
—
484339
HEALTHLINK
MO
Enumeration date
05/25/2006
Last updated
07/18/2013
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