Healthcare Provider Details

I. General information

NPI: 1760571004
Provider Name (Legal Business Name): FRANK GLOVER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5050 JOY RD
DETROIT MI
48204-2263
US

IV. Provider business mailing address

8500 14TH ST
DETROIT MI
48206-2425
US

V. Phone/Fax

Practice location:
  • Phone: 313-894-4004
  • Fax: 313-894-1729
Mailing address:
  • Phone: 313-894-3950
  • Fax: 313-894-1729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberFG005662
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: