Glen Burnie Endoscopy Center, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

GLEN BURNIE ENDOSCOPY CENTER, LLC

Practice address

4 Mountain Rd
Glen Burnie, MD 21060-7974

Phone

(410) 659-2963

Fax

(410) 332-9789

NPI assigned

May 27, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Justin Deibel, DEIBEL

Title

Executive Vice President/Cfo

Phone

(410) 659-2905

Specialties & licenses 3

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1779840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779840000000",
    "number": "1871424085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ST PAUL PLACE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022102",
            "telephone_number": "410-659-2963",
            "fax_number": "410-332-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MOUNTAIN RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210607974",
            "telephone_number": "410-659-2963",
            "fax_number": "410-332-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN BURNIE ENDOSCOPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-27",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A",
        "authorized_official_last_name": "DEIBEL",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT/CFO",
        "authorized_official_telephone_number": "410-659-2905",
        "authorized_official_credential": "DEIBEL"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lara Gilmore, CRNA
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• Stephanie K Glassman, PSY.D.
• Stephanie Gleason
• Glen Burnie Chiropractic and Physical Therapy LLC
• Glen Burnie Health Center
• Glen Burnie MD Endoscopy ASC LLC
• Glen Burnie Oral Surgery Associates PC
• Glen Burnie Pharmacy
• Glen Burnie Physical Therapy & Sportscare, LLC

• Surgery Physician in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.