Provider Demographics
NPI:1689440067
Name:GLOVER, SIDNEY LAMAR JR (MED, LBS)
Entity Type:Individual
Prefix:MR
First Name:SIDNEY
Middle Name:LAMAR
Last Name:GLOVER
Suffix:JR
Gender:M
Credentials:MED, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 STAMBAUGH AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-2775
Mailing Address - Country:US
Mailing Address - Phone:724-431-9512
Mailing Address - Fax:724-981-1919
Practice Address - Street 1:87 STAMBAUGH AVE UNIT B
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-2775
Practice Address - Country:US
Practice Address - Phone:724-431-9512
Practice Address - Fax:724-981-1919
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst