Individual provider Active NPI

Mary Hollingsworth Bowdre Glover, M.D.

  • Dermatology Physician
  • Myrtle Beach, SC
National Provider Identifier
1720309941
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
36712 Issued in SC
Practice address
933 Medical Cir
Myrtle Beach, SC 29572-4116
Phone
(843) 215-1100
Fax
(843) 215-1211
NPI assigned
Jun 22, 2010
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 36712 SC Primary

Addresses

Primary practice location

933 Medical Cir
Myrtle Beach, SC 29572-4116

Mailing address

7410 Highway 707
Myrtle Beach, SC 29588-7304
Phone (843) 215-1100

Other practice location 1

7410 Highway 707
Myrtle Beach, SC 29588-7304
Phone (843) 215-1100 ext. 350

Other identifiers 2

IdentifierTypeStateIssuer
0233298OtherCIGNA
12717246OtherCAQH

Other names 1

  • Dr. Mary Hollingsworth Bowdre Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140801001133 SC Practitioner - Dermatology 3577702992 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of South Carolina School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Strand DermatologyGroup PAC ID 8921067596, 8 clinicians

Practice addresses (Care Compare)

7410 Hwy 707
Myrtle Beach, SC 29588-7304
Phone (843) 215-1100

933 Medical Cir
Myrtle Beach, SC 29572-4116
Phone (843) 215-1100

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
77.59
Improvement activities
40
Cost
79.09

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision91
Removal of skin lesions3548
Removal of skin cancer131
Removal or shaving of skin growth82
Skin biopsy750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Strand Dermatology Dermatology CurrentSince Aug 1, 2014 Accepting new patients
Robert S Purvis, MD, LLC Dermatology PastSince Mar 26, 2023 Accepting new patients

Locations

3001 Newcastle Loop
Myrtle Beach, SC 29588
Phone (843) 215-1100

933 Medical Cir
Myrtle Beach, SC 29572
Phone (843) 215-1100

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1720309941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7410 HIGHWAY 707",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295887304",
            "telephone_number": "843-215-1100",
            "fax_number": "843-215-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 MEDICAL CIR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724116",
            "telephone_number": "843-215-1100",
            "fax_number": "843-215-1211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7410 Highway 707",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295887304",
            "country_code": "US",
            "telephone_number": "843-215-1100 x350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLOVER",
        "first_name": "MARY",
        "middle_name": "HOLLINGSWORTH BOWDRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "36712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0233298",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12717246",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BOWDRE",
            "middle_name": "HOLLINGSWORTH",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.