Individual
DR. RICHARD E. GLIKLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
243 CHARLES ST, BOSTON, MA 02114-3002
(617) 573-4458
Mailing address
243 CHARLES ST, BOSTON, MA 02114-3002
(617) 573-4458
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
77417
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3107493
—
MA
Enumeration date
10/31/2005
Last updated
11/06/2013
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