GLEN EDWARD TATE MD
NPI 1720082555
Family Medicine in Laurel Fork, VA

Active since June 09, 2005
14558 DANVILLE PIKE, LAUREL FORK, VA 24352(276) 398-2292(276) 398-3331 Get Directions Write a Review

NPPES record last updated: March 5, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Glen Edward Tate Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLEN EDWARD TATE MD (NPI 1720082555) is an individual family medicine provider in Laurel Fork, Virginia, licensed in Virginia (0101034417) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1720082555
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameGLEN EDWARD TATECredential: MD
Location Address14558 DANVILLE PIKELaurel Fork, VA 24352-3982
Mailing AddressPo Box 9Laurel Fork, VA 24352-0009 · (276) 398-2292 · Fax (276) 398-3331
Fax(276) 398-3331
Sole ProprietorNo
Enumeration DateJune 9, 2005
Last NPPES UpdateMarch 5, 2021
NPPES CertifiedMarch 5, 2021
NPI 1720082555 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in VA · 0101034417
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

14558 DANVILLE PIKE, Laurel Fork, VA 24352

Other Identifiers 1

Medicaid007608942VA

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist (Clinical)
14558 DANVILLE PIKE
LAUREL FORK, VA 24352
Nurse Practitioner (Family)
14558 DANVILLE PIKE
LAUREL FORK, VA 24352
Nurse Practitioner (Family)
14558 DANVILLE PIKE
LAUREL FORK, VA 24352
Counselor (Professional)
14558 DANVILLE PIKE
LAUREL FORK, VA 24352
Health Educator
14558 DANVILLE PIKE
LAUREL FORK, VA 24352
Pharmacist
14558 DANVILLE PIKE
LAUREL FORK, VA 24352
Pharmacist
14558 DANVILLE PIKE
LAUREL FORK, VA 24352
Nurse Practitioner (Family)
14558 DANVILLE PIKE
LAUREL FORK, VA 24352

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glen Tate's NPI number?

The NPI number for Glen Tate is 1720082555. It was assigned to this individual provider in the NPPES registry on June 9, 2005.

Where is Glen Tate located?

Glen Tate practices at 14558 Danville Pike, Laurel Fork, VA 24352. The listed phone number is (276) 398-2292.

What is Glen Tate's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Glen Tate was last updated on March 5, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.