Individual
DR. MARC BERNARD GLADDEN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
705 S UNIVERSITY AVE STE 200, BEAVER DAM, WI 53916-3079
(920) 887-9272
Mailing address
705 S UNIVERSITY AVE STE 200, BEAVER DAM, WI 53916-3079
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
62570-20
WI
208M00000X
Hospitalist Physician
62570-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2011
Last updated
01/14/2021
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