Healthcare Provider Details

I. General information

NPI: 1487043469
Provider Name (Legal Business Name): AARON GLOVER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2015
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7209 CREEDMOOR RD STE 105
RALEIGH NC
27613-1695
US

IV. Provider business mailing address

7209 CREEDMOOR RD STE 105
RALEIGH NC
27613-1695
US

V. Phone/Fax

Practice location:
  • Phone: 919-307-9461
  • Fax: 919-714-0909
Mailing address:
  • Phone: 919-307-9461
  • Fax: 919-714-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001013592
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: