Individual
CAROL MADISON GLOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
750 TOWNPARK LN NW, KAISER PERMANENTE TOWN PARK MEDICAL CENTER, KENNESAW, GA 30144-5579
(404) 365-0966
(770) 422-2049
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7070
(770) 422-2049
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
028987
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00808948
—
GA
Enumeration date
01/22/2007
Last updated
01/07/2022
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