Individual
MR. SAMUEL GLADSTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12 DICKINSON ST, AMHERST, MA 01002-2310
(413) 253-2300
(413) 256-0464
Mailing address
12 DICKINSON ST, AMHERST, MA 01002-2310
(413) 253-2300
(413) 256-0464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
55035
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007610
BMC
MA
01
—
10248501
CIGNA
MA
01
—
12640
HNE
MA
01
—
2358324
AETNA
MA
05
—
3029671
—
MA
01
—
706042
CONNECTICARE
MA
01
—
71777
HARVARD PILGRIM
MA
01
—
720950
TUFTS
MA
01
—
J06871
BCBSMA
MA
Enumeration date
03/20/2006
Last updated
11/28/2012
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