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Individual

DR. OMAR GLADWIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1220 DEWEY AVE, MILWAUKEE, WI 53213-2504
(414) 454-6600
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
65113
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100059833
WI
05
1417213190
WI
Enumeration date
04/06/2012
Last updated
07/29/2025
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