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Individual

DR. THOMAS HARTER GLICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1493 CAMBRIDGE ST, CAMBRIDGE HOSPITAL, CAMBRIDGE, MA 02139
(617) 665-1017
(617) 665-1671
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
56325
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0151351
MA
01
P00275963
RR MEDICARE
Enumeration date
02/02/2006
Last updated
03/17/2008
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