Richard Saul Glick, D.O.

Individual provider Active NPI General Practice Physician · Dresher, PA

NPI 1104989482 · NPPES record last updated Aug 12, 2008

Key facts

NPI
1104989482
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
OS002648L (PA)
Practice address
1444 Candlebrook Dr
Dresher, PA 19025-1023
Phone
(215) 635-0333
Fax
(215) 885-1721
NPI assigned
Dec 18, 2006
Sex
Male
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 Osteopathy

State licenses

LicenseStateTypeSpecialty
OS002648LPAMDGynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X OS002648L PA
General Practice Physician 208D00000X OS002648L PA Yes

Addresses

Primary practice location

1444 Candlebrook Dr
Dresher, PA 19025-1023

Mailing address

1444 Candlebrook Dr
Dresher, PA 19025-1023
Phone (215) 635-0333

Other identifiers

IdentifierTypeStateIssuer
0045371000OtherPAHMO ID
000090349OtherPAHIGHMARK BLUE SHIELD ID

Other providers in Dresher, PA

All providers in Dresher, PA · General Practice Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.