Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Glen Edward Tate, MD

Individual provider Family Medicine Physician · NPI 1720082555

Glen Edward Tate, MD is a Family Medicine Physician in Laurel Fork, Virginia. Licensed in Virginia. Registered with an NPI since 2005.

Licensed in
VA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

14558 Danville Pike
Laurel Fork, VA 24352-3982
Phone: (276) 398-2292
Fax: (276) 398-3331
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0101034417 (VA)

Record details

NPI number1720082555
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 9, 2005
Last updated in NPPESMarch 5, 2021
Certification dateMarch 5, 2021
Mailing addressPo Box 9, Laurel Fork, VA 24352-0009

Other providers in Laurel Fork