Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 38652 | SC |
N | 207V00000X | Obstetrician & Gynecologist | MD019496 | TN |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 38652 | SC |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD19496 | TN |
N | 207VG0400X | Gynecologist | 38652 | SC |
NPI | 1295814390 |
---|---|
Provider Name | Gregory L Glover |
First Address | Beaufort, SC 29902-6127 |
Second Address | Beaufort, SC 29902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 16/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103I161265 | (02) | TN |
3045103 | (05) | TN |
386521 | (05) | SC |
C74769 | (02) |