Provider Demographics
NPI:1316998537
Name:GLAZIER, MARIA GINA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:GINA
Last Name:GLAZIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 WATERCOVE RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-3982
Mailing Address - Country:US
Mailing Address - Phone:804-744-0200
Mailing Address - Fax:804-744-8417
Practice Address - Street 1:3000 WATERCOVE RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-3982
Practice Address - Country:US
Practice Address - Phone:804-744-0200
Practice Address - Fax:804-744-8417
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231413207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA540883363OtherGREAT WEST HEALTHCARE
VA13830OtherCIGNA
VA540883363OtherFIRST HEALTH/CCN
VA898227OtherMAMSI
VA540883363OtherPREFERRED CARE
VA540883363OtherVIRGINIA HEALTH NETWORK
VA540883363OtherCHAMPUS-TRICARE
VA0103012OtherUNITED HEALTHCARE
VA384536OtherANTHEM
VA540189OtherAETNA
VA66489OtherOPTIMA
VA5640610Medicaid
VA153009OtherSOUTHERN HEALTH
VA540883363OtherPHCS
VA540883363OtherGREAT WEST HEALTHCARE
VAG77449Medicare UPIN
VA13830OtherCIGNA
VA153009OtherSOUTHERN HEALTH
VA016334V28Medicare PIN