Organization
SAMUEL GLADSTONE, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL GLADSTONE MD (PHYSICIAN OWNER)
(413) 253-2300
Entity
Organization
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
—
01
—
10248501
CIGNA
MA
01
—
12640
HEALTH NEW ENGLAND
MA
01
—
1293872
FALLON
MA
01
—
222909447
MULTIPLAN
MA
01
—
2358324
AETNA
MA
05
—
3029671
—
MA
01
—
706042
CONNECTICARE
MA
01
—
71777
HARVARD PILGRIM
MA
01
—
720950
TUFTS
MA
01
—
J06871
BCBS
MA
Enumeration date
07/01/2008
Last updated
07/01/2008
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