Provider Demographics
NPI:1538138102
Name:GLOVER, MICHAEL G (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:G
Last Name:GLOVER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 3148
Mailing Address - Street 2:1803 FOREST HILLS RD
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27895-3148
Mailing Address - Country:US
Mailing Address - Phone:252-243-9629
Mailing Address - Fax:252-243-0915
Practice Address - Street 1:1803 FOREST HILLS RD
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893
Practice Address - Country:US
Practice Address - Phone:252-243-9629
Practice Address - Fax:252-243-0915
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2007-08-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC39268207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8935999Medicaid
NC8935999Medicaid
2151573BMedicare ID - Type Unspecified