Individual
DR. RICHARD J GLUCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5086 SCHOFIELD CT., POWDER SPRINGS, GA 30127
(404) 433-1788
(678) 403-2572
Mailing address
5086 SCHOFIELD CT., POWDER SPRINGS, GA 30127
(404) 433-1788
(678) 403-2572
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
013892
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000110602L
—
GA
05
—
00110602A
—
GA
Enumeration date
06/06/2006
Last updated
07/22/2014
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