Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GLEN EDWARD TATE, MD
ActiveGLEN EDWARD TATE, MD is a Family Medicine healthcare provider located in LAUREL FORK, Virginia. NPI 1720082555 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · LAUREL FORK, VA
Registration Details
- NPI Number
- 1720082555
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 9, 2005 (21.176829473677 yrs)
- Last Updated
- Mar 5, 2021
- License
-
0101034417 (VA)
Practice Information
- Address
-
14558 DANVILLE PIKELAUREL FORK, VA, 243523982Browse VA providers · Browse ZIP 24352
- Phone
- 2763982292
- Fax
- 2763983331
- Primary Specialty
-
Family Medicine
207Q00000X
Other Family Medicine Providers in LAUREL FORK, VA
| Name | Credential | NPI |
|---|---|---|
| JEFFREY STEWART PEELE | MD | 1396774758 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.