Individual
DR. WENDELL GLOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11 PROFESSIONAL PKWY, RIDGELAND, MS 39157-4114
(601) 856-2460
(601) 856-5363
Mailing address
11 PROFESSIONAL PKWY, RIDGELAND, MS 39157-4114
(601) 856-2460
(601) 856-5363
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
11734
MS
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
11734
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B2825WS4MS
—
MS
Enumeration date
04/09/2015
Last updated
10/03/2023
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