Provider Demographics
NPI:1194058404
Name:GLASER, JORDAN MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:MICHAEL
Last Name:GLASER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5221 PARAMOUNT PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-5490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4901 DAWN DR STE 2300
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28360-8287
Practice Address - Country:US
Practice Address - Phone:910-738-1065
Practice Address - Fax:910-738-5143
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC201701602207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty