MEDICARE: GREGORY L GLOVER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MD019496	TN
2	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	38652	SC
3	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician	MD19496	TN
4	207VG0400X	Gynecology Physician	38652	SC
5	207V00000X	Obstetrics & Gynecology Physician	38652	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295814390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY L GLOVER MD

Provider Business Mailing Address
First Line	:	1264 RIBAUT RD STE 200
Second Line	:
City	:	BEAUFORT
State	:	SC
Zip	:	29902-6127
Country	:	US
Telephone Number	:	843-524-2466
Fax Number	:	843-379-2456

Provider Business Practice Location Address
First Line	:	1264 RIBAUT RD STE 200
Second Line	:
City	:	BEAUFORT
State	:	SC
Zip	:	29902
Country	:	US
Telephone Number	:	843-524-2466
Fax Number	:	843-379-2456

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	11/16/2020

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