Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 305115 | LA |
N | 111NI0900X | Internist | 305115 | LA |
Y | 207RH0002X | Hospice and Palliative Medicine | 305115 | LA |
NPI | 1245330125 |
---|---|
Provider Name | Marcia H Glass |
First Address | New Orleans, LA 70112-2632 |
Second Address | New Orleans, LA 70112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 07/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
71-1004783 | TAX ID (01) | LA |