Provider Demographics
NPI:1285994780
Name:GLOVER, BRANDON T (DO)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:T
Last Name:GLOVER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1400 E BOULDER ST STE 700
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5533
Mailing Address - Country:US
Mailing Address - Phone:719-365-7300
Mailing Address - Fax:719-365-7301
Practice Address - Street 1:4110 BRIARGATE PKWY STE 405
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7838
Practice Address - Country:US
Practice Address - Phone:719-365-7300
Practice Address - Fax:719-365-7301
Is Sole Proprietor?:No
Enumeration Date:2012-05-18
Last Update Date:2021-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI51010197852084N0400X
CODR.00631962084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology