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).
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 |
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 |
Street Address |
25050 SE STARK STREET LEGACY MT HOOD MULTISPECIALTY CLINIC |
City | GRESHAM |
State | OR |
Zip Code | 97030 |
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 |
Find all providers in zip 97030 |
Taxonomy Code | 207RP1001X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Pulmonary Disease |
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. |
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 |
Find all providers with the same taxonomy |
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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.