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General NPI Number Information
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NPI Number | 1649185133
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Entity Type | Individual
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Provider Name | ALEXIS MAE GLOVER PA
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Gender | Female
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Dates
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Enumeration Date | 08/18/2026
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Last Update Date | 08/18/2026
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Provider Practice Location Address
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Address Line | 11731 POINTE PL
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City | ROSWELL
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State | GA
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Zip | 30076-4636
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Country | US
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Telephone | 770-284-3150
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Fax |
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Provider Business Mailing Address
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Address Line | 40 OLD FRIENDSHIP LN
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City | DAWSONVILLE
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State | GA
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Zip | 30534-7365
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Country | US
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Telephone | 678-897-8732
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 14128
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License Number State | GA
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