Raimund R Glosson, PHYSICIAN ASSISTANT
Individual provider Active NPI Surgical Physician Assistant · Fort Eustis, VA
NPI 1477543379 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1477543379
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 0110001204 (VA)
- Practice address
- 576 Jefferson Ave
Fort Eustis, VA 23604-1602 - Phone
- (757) 314-7595
- Fax
- (757) 314-7601
- NPI assigned
- Oct 24, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0110001204 | VA | MD | Surgical Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 0110001204 | VA | Yes |
Addresses
Primary practice location
576 Jefferson Ave
Fort Eustis, VA 23604-1602
Mailing address
104 York LN
Yorktown, VA 23692-4029
Phone (757) 890-2710
Other providers in Fort Eustis, VA
- Ramesh Gautam
- Keitra Tunisha George
- Sara Gillette
- Richard Daivd Glaeser
- Jeffrey Thomas Glasser
- Virginia A Glover
- Victoria Godwin
- Franciene Golding
- John Lee Goldstone
- Michael Keesee Gregory
All providers in Fort Eustis, VA · Surgical Physician Assistant in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. 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.