Provider Demographics
NPI:1043282569
Name:GLAMOUR, TEJINDER S (MD)
Entity type:Individual
Prefix:DR
First Name:TEJINDER
Middle Name:S
Last Name:GLAMOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 EXECUTIVE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-5323
Mailing Address - Country:US
Mailing Address - Phone:727-347-0005
Mailing Address - Fax:727-541-6558
Practice Address - Street 1:6225 66TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-5025
Practice Address - Country:US
Practice Address - Phone:727-521-0994
Practice Address - Fax:727-522-2671
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68156207RI0008X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL06252OtherUNIVERSAL
5778089OtherAETNA PPO
26488OtherWELLCARE
100011830OtherRAILROAD MEDICARE
26787OtherBC/BS
335878OtherMEDIGAP
5797313OtherGHI
870239OtherCCN
268039400OtherCITRUS
26488OtherSTAYWELL
FL377868100Medicaid
2256218OtherAETNA HMO
335878OtherMEDIGAP
F13550Medicare UPIN
FL26787TMedicare PIN