Provider Demographics
NPI:1295990091
Name:DEBIAS, GLENN (DO)
Entity type:Individual
Prefix:
First Name:GLENN
Middle Name:
Last Name:DEBIAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HYDE PARK
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-6615
Mailing Address - Country:US
Mailing Address - Phone:215-230-1804
Mailing Address - Fax:215-230-4228
Practice Address - Street 1:110 HYDE PARK
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-6615
Practice Address - Country:US
Practice Address - Phone:215-230-1804
Practice Address - Fax:215-230-4228
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-004824-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine