Basic Information
| Provider Information | |||||||||
| NPI: | 1043282569 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GLAMOUR | ||||||||
| FirstName: | TEJINDER | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3001 EXECUTIVE DR STE 130 | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337625323 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273470005 | ||||||||
| FaxNumber: | 7275416558 | ||||||||
| Practice Location | |||||||||
| Address1: | 6225 66TH ST N | ||||||||
| Address2: | |||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337815025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275210994 | ||||||||
| FaxNumber: | 7275222671 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2006 | ||||||||
| LastUpdateDate: | 05/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0008X | ME68156 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hepatology | 207RG0100X | ME68156 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 06252 | 01 | FL | UNIVERSAL | OTHER | 5778089 | 01 | AETNA PPO | OTHER | 26488 | 01 | WELLCARE | OTHER | 100011830 | 01 | RAILROAD MEDICARE | OTHER | 26787 | 01 | BC/BS | OTHER | 335878 | 01 | MEDIGAP | OTHER | 5797313 | 01 | GHI | OTHER | 870239 | 01 | CCN | OTHER | 268039400 | 01 | CITRUS | OTHER | 26488 | 01 | STAYWELL | OTHER | 377868100 | 05 | FL | MEDICAID | 2256218 | 01 | AETNA HMO | OTHER |