Provider Demographics
NPI:1760547913
Name:GLOVER, ROBERT V JR (MD, FACC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:V
Last Name:GLOVER
Suffix:JR
Gender:M
Credentials:MD, FACC
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:V
Other - Last Name:GLOVER
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MD, PC
Mailing Address - Street 1:810 13TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-1333
Mailing Address - Country:US
Mailing Address - Phone:229-432-1818
Mailing Address - Fax:229-432-1933
Practice Address - Street 1:810 13TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1333
Practice Address - Country:US
Practice Address - Phone:229-432-1818
Practice Address - Fax:229-432-1933
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036161207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000531803AMedicaid
GAF47716Medicare UPIN
GA11BDFVJMedicare PIN