Organization
ADVANCED GASTRO & LIVER CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TEJUNDER S GLAMOUR MD (PRESIDENT)
(727) 521-0994
Entity
Organization
Contact information
Practice address
6225 66TH ST N, PINELLAS PARK, FL 33781-5025
(727) 521-0994
(727) 522-2671
Mailing address
PO BOX 20267, TAMPA, FL 33622-0267
(727) 823-2188
(727) 828-0823
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME68156
FL
207RI0008X
Hepatology Physician
ME68156
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
268039400
MCD
—
01
—
34875
BCBS - GROUP #
—
01
—
DA8281
MCR RR
—
Enumeration date
02/15/2006
Last updated
02/23/2010
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