GLASS DERMATOLOGY PLLC NPI 1184299034

NPI Information

NPI: 1184299034
Provider Name: GLASS DERMATOLOGY PLLC
Classification: Clinic/Center - 261QM2500X
Specialization: Medical Specialty
Entity Type: Organization
CLIA Number: 34D2254938
Address: 412 E JOHNSON ST
CLINTON, NC
ZIP 28328
Phone: (910) 490-1240

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NPI Details

GLASS DERMATOLOGY PLLC is a medical specialty clinic center in Clinton, NC. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). GLASS DERMATOLOGY PLLC NPI is 1184299034. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

412 E JOHNSON ST
CLINTON, NC
ZIP 28328-806
Phone: (910) 490-1240
Fax: (910) 490-1260

The provider's authorized official is Alexandria B Glass .
The authorized official title is Physician/owner and has the following contact phone number (910) 990-7722.

The CLIA number assigned to this NPI record is 34D2254938 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/24/2021 and was last updated on 3/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207N00000X	Dermatology				No
2	261QM2500X	Clinic/Center	Medical Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	202101095	OTHER	NORTH CAROLINA	NC MEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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