Individual
STEPHEN J GLUCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
51 N 39TH ST, MAB, SUITE 102, PHILADELPHIA, PA 19104-2640
(215) 662-9990
(215) 243-3297
Mailing address
51 N. 39TH STREET, MAB, SUITE 102, PHILADELPHIA, PA 19104-2640
(215) 662-9990
(215) 243-3297
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD013642E
PA
207RI0200X
Infectious Disease Physician
Primary
MD013642E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006385480003
—
PA
Enumeration date
06/27/2006
Last updated
05/31/2016
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