Individual
DR. NEIL S GLADSTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
81 UPPER RIVERDALE RD, SUITE 210, RIVERDALE, GA 30274-2627
(770) 996-1200
(770) 907-7492
Mailing address
PO BOX 962380, RIVERDALE, GA 30296-6921
(770) 996-1200
(770) 907-7492
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
016917
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00113759B
—
GA
Enumeration date
10/25/2006
Last updated
09/05/2013
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