Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 39268 | NC |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 39268 | NC |
NPI | 1538138102 |
---|---|
Provider Name | Dr. Michael G Glover |
First Address | Wilson, NC 27895-3148 |
Second Address | Wilson, NC 27893 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 17/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8935999 | (05) | NC |
E67486 | (02) |