Basic Information
| Provider Information | |||||||||
| NPI: | 1275531501 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GLASSMAN | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 776351 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606776351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025889490 | ||||||||
| FaxNumber: | 5022725116 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 E GRAY ST | ||||||||
| Address2: | SUITE 900 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402023900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025847525 | ||||||||
| FaxNumber: | 5025890849 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2005 | ||||||||
| LastUpdateDate: | 01/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XS0117X | 27001 | KY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Surgery of the Spine |
ID Information
| ID | Type | State | Issuer | Description | 100373900 | 05 | IN | MEDICAID | 163722400 | 01 | KY | US DEPT OF LABOR | OTHER | N294333 | 01 | HARMONY | OTHER | 2433678000 | 01 | KY | PASSPORT ADVANTAGE (SPINE | OTHER | P00344319 | 01 | KY | RAILROAD MEDICARE (UNIVER | OTHER | 00533163 | 01 | KY | MEDICARE/NLS | OTHER | 1054524 | 01 | KY | PASSPORT (SPINE INSTITUTE | OTHER | 64270010 | 05 | KY | MEDICAID | 0219793 | 01 | WA | WASHINGTON DEPT OF LABOR | OTHER | 000000049463 | 01 | KY | ANTHEM / SPINE INSTITUTE | OTHER | 1049635 | 01 | KY | PASSPORT (UNIVERSITY ORTH | OTHER | 2432611000 | 01 | KY | PASSPORT ADVANTAGE (UNIVE | OTHER | 000000049343 | 01 | KY | ANTHEM / UNIV ORTHO ASSOC | OTHER | 200007232 | 01 | KY | RAILROAD MEDICARE (SPINE | OTHER |