Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 2016-00778 | NC |
NPI | 1447517271 |
---|---|
Provider Name | Angelica Vanessa Glover |
First Address | Charlotte, NC 28260-0447 |
Second Address | Charlotte, NC 28204-3280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2012 |
Last Update Date | 13/08/2021 |