Glen Edward Tate, MD

NPI #1720082555 in Laurel Fork, Virginia

Provider Information

NPI Number: 1720082555
Entity Type: Individual
Name: Glen Edward Tate, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Family Medicine
Credential: MD
Enumeration Date: Jun 9, 2005
Last Updated: Mar 5, 2021

Practice Location

Address: 14558 DANVILLE PIKE
City: Laurel Fork
State: Virginia
ZIP Code: 24352-3982
Phone: (276) 398-2292

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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Organizations

Provider Name	Specialty	City
Laurel Fork Family Practice	Family Medicine	Laurel Fork	AI Deep Dive

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