SAMUEL R. GLICKMAN


Address: 25050 Se Stark Street, Legacy Mt Hood Multispecialty Clinic, Gresham, OR 97030
Phone: 5034135702

SAMUEL R. GLICKMAN (NPI# 1912149790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912149790
Entity Type Individual
Full Name SAMUEL R. GLICKMAN
Credential M.D.
Practice Address 25050 Se Stark Street
Legacy Mt Hood Multispecialty Clinic
Gresham
OR 97030
Practice Telephone 5034135702
Practice Fax Number 5034136499
Mailing Telephone 5034135702
Mailing Fax Number 5034136499
Enumeration Date 2009-03-25
Last Update Date 2016-08-23
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RP1001X Internal Medicine
Specialization: Pulmonary Disease
MD177588 OR Allopathic & Osteopathic Physicians
N 208M00000X Hospitalist 265576 NY Allopathic & Osteopathic Physicians
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Office Location

Street Address 25050 SE STARK STREET
LEGACY MT HOOD MULTISPECIALTY CLINIC
City GRESHAM
State OR
Zip Code 97030

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174032312 Tiffany Chen Occupational Therapist 304 Ne Hood Ave., Gresham, OR 97030 2017-09-20
1225568454 Goldstar Vascular Access, Inc Home Infusion 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 2017-06-20
1861940454 Jessica Morrow Massage Therapist 1748 Nw Fairview Dr., Gresham, OR 97030 2016-09-13
1033665898 Bonita Baxter Counselor 400 Ne 7th Street, Gresham, OR 97030 2016-08-31
1710335484 Ethan William Hoccom Counselor 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 2016-06-02
1992159610 Kathleen Kline, Lmt Massage Therapist 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 2016-04-19
1215390109 The Wallace Medical Concern Nurse Practitioner 254 Nw Burnside Road, Gresham, OR 97030 2016-03-30
1932568912 Atchison Dialysis, LLC Clinic/Center 878 Nw Burnside Rd, Gresham, OR 97030 2016-02-18
1912374034 Hilary Dawn Montgomery Counselor 1326 Nw Civic Dr # 5569, Gresham, OR 97030 2015-08-24
1992171730 Melissa E Childs Massage Therapist 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 2015-08-17
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Taxonomy Information

Taxonomy Code 207RP1001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Pulmonary Disease

Taxonomy Definition

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1073073250 Good Samaritan Hospital Corvallis Internal Medicine 3640 Nw Samaritan Dr Ste 100c, Corvallis, OR 97330-3784 2019-03-22
1730672411 Lawrence Edward Permen Internal Medicine 25139 Allure Ave, Veneta, OR 97487-8713 2018-06-07
1053754069 Dr Bob Health Centre Internal Medicine 16325 Sw Sexton Mountain Dr, Beaverton, OR 97007 2013-04-09
1427303122 Karishma Parekh Internal Medicine 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 2012-07-18
1750648432 Robert Dreisin Internal Medicine 6350 Sw Burlingame Ave, Portland, OR 97239-2635 2012-04-18
1982984142 Frank Nelson Turner Internal Medicine 2260 Marcola Rd, Springfield, OR 97477-2594 2011-08-19
1619209756 Ana Maria Ponea Internal Medicine 364 Se 8th Ave Ste 301a, Hillsboro, OR 97123-5273 2010-01-30
1962645549 Elham Karamooz Internal Medicine Ohsu, 3181 Sw Sam Jackson Park Road, Portland, OR 97239 2009-04-13
1831368554 Ohsu Medical Group Internal Medicine 2115 Sw River Pkwy, Portland, OR 97201-8024 2008-02-27
1043496532 Keri Kay Brown Internal Medicine 2055 Exchange St Ste 210, Astoria, OR 97103 2008-01-14
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Competitor

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City GRESHAM
Zip Code 97030

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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