Glass, Kevin L

Glass, Kevin L is an individual health care provider with primary practice located at 3650 Joseph Siewick Dr Ste 307, Fairfax VA 22033-1715. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Glass, Kevin L can be contacted via phone (703) 391-8804.

Contact Information

Primary practice address
3650 Joseph Siewick Dr Ste 307 Fairfax VA 22033-1715
Phone: (703) 391-8804
Fax: (703) 391-5659
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 0101232697 Virginia
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 0101232697 Virginia

Profile Details

NPI number 1417959743
LBN Legal business name Glass, Kevin L
Credentials M..
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2005
Last updated Dec 5th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417959743 NPPES
Virginia MEDICAID 5872278

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