Active NPI
Mark Andrew Glover, DO
- Surgery Physician
- Pontiac, MI
National Provider Identifier
1336723816
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 5151015028
- Practice address
- 44405 Woodward Ave # H-23
Pontiac, MI 48341-5023 - Phone
- (248) 858-3234
- NPI assigned
- May 10, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 5151015028 | MI | Primary |
Addresses
Primary practice location
44405 Woodward Ave # H-23
Pontiac, MI 48341-5023
Mailing address
44405 Woodward Ave # H-23
Pontiac, MI 48341-5023
Phone (248) 858-3234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Interoperability endpoints
- mglover1043426@direct.trinity-health.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620604800000",
"number": "1336723816",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE # H-23",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-858-3234",
"fax_number": "248-858-3242"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE # H-23",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-858-3234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLOVER",
"first_name": "MARK",
"middle_name": "ANDREW",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-10",
"last_updated": "2021-05-10",
"certification_date": "2021-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "5151015028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.