Jerilyn Kay Glass, M.D.
Individual provider Active NPI Neurological Surgery Physician · Boyds, MD
NPI 1104160787 · NPPES record last updated Nov 20, 2012
Key facts
- NPI
- 1104160787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurological Surgery Physician 207T00000X
- License
- D0042957 (MD)
- Practice address
- 18510 Black Kettle Dr
Boyds, MD 20841-4310 - Phone
- (301) 515-1091
- NPI assigned
- Nov 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0042957 | MD | MD | Neurological Surgery Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | D0042957 | MD | Yes |
Addresses
Primary practice location
18510 Black Kettle Dr
Boyds, MD 20841-4310
Mailing address
18510 Black Kettle Dr
Boyds, MD 20841-4310
Phone (301) 515-1091
Other providers in Boyds, MD
- Pamela June Dixon Mitchell
- Marcelline Ndonfack Enyeji
- Erin L. Koch and Associates
- Joan Furlani
- Ana-Alicia Garcia
- Gabrielle Liann Go
- Mackenzie Goodwyn
- Anju Gurung
- Healthcare Professionals Medical Group, P.a.
- Healthcare Professionals Medical Group, P.a.
All providers in Boyds, MD · Neurological Surgery Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.