Provider Demographics
NPI:1174637300
Name:GLOVER, SARAH CAMILLE (DO)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CAMILLE
Last Name:GLOVER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CANAL ST FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-3018
Mailing Address - Country:US
Mailing Address - Phone:504-962-6099
Mailing Address - Fax:
Practice Address - Street 1:2000 CANAL ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3018
Practice Address - Country:US
Practice Address - Phone:504-962-6099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103967207R00000X
MS26365207RG0100X
LA335831207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2578073Medicaid
FL003119200Medicaid
FLEO512ZMedicare PIN
FL003119200Medicaid