Provider Demographics
NPI:1316910128
Name:UBER, GLENN M (DO)
Entity type:Individual
Prefix:DR
First Name:GLENN
Middle Name:M
Last Name:UBER
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Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 1549
Mailing Address - Street 2:BUTLER MEDICAL PROVIDERS
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1549
Mailing Address - Country:US
Mailing Address - Phone:724-794-4023
Mailing Address - Fax:724-794-3675
Practice Address - Street 1:100 INNOVATION DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057
Practice Address - Country:US
Practice Address - Phone:724-794-4023
Practice Address - Fax:724-794-3675
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2018-07-10
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Provider Licenses
StateLicense IDTaxonomies
PAOS017368207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102988815 0001Medicaid
PA102988815 0001Medicaid
KY64025257Medicaid
PA102988815 0001Medicaid
PA382280ECTMedicare Oscar/Certification