Provider Demographics
NPI:1659592236
Name:GLOVER, WILLIAM BRYAN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRYAN
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 1:2020 21ST AVE S
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4354
Mailing Address - Country:US
Mailing Address - Phone:615-269-0652
Mailing Address - Fax:615-269-0135
Practice Address - Street 1:3441 DICKERSON PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37207-2539
Practice Address - Country:US
Practice Address - Phone:615-769-4401
Practice Address - Fax:615-769-4730
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-00600207P00000X
TN47088207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
810619OtherPARTNERS
NC5906792Medicaid
VA1659592236Medicaid
WV3810009146Medicaid
198804OtherMEDCOST
9436073OtherAETNA
SCQ0060PMedicaid
145PKOtherBCBS
TN1523491Medicaid
145PKOtherBCBS
NC5906792Medicaid