Healthcare Provider Details

I. General information

NPI: 1598349110
Provider Name (Legal Business Name): CALEB MARK GLOVER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2021
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 COLLINS RD
LANSING MI
48910-8394
US

IV. Provider business mailing address

1650 RAMBLEWOOD DR STE 200
EAST LANSING MI
48823-7397
US

V. Phone/Fax

Practice location:
  • Phone: 517-975-6000
  • Fax:
Mailing address:
  • Phone: 517-332-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number5151016416
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: