Provider Demographics
NPI:1104839547
Name:GLOVER, HILLEL (MD)
Entity Type:Individual
Prefix:DR
First Name:HILLEL
Middle Name:
Last Name:GLOVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 20509
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:MN
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:201-568-8288
Mailing Address - Fax:518-926-6983
Practice Address - Street 1:403 STONY LANDING RD
Practice Address - Street 2:
Practice Address - City:MONCKS CORNER
Practice Address - State:SC
Practice Address - Zip Code:29461-3967
Practice Address - Country:US
Practice Address - Phone:843-761-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC887622084P0800X
NY1014372084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A63041Medicare UPIN