Individual
DR. GARY F GLADIEUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5757 MONCLOVA RD, SUITE 10, MAUMEE, OH 43537-1863
(419) 887-0803
(419) 887-0817
Mailing address
3606 GREENLAWN CT, TOLEDO, OH 43614-5119
(419) 385-8029
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35-05-6893-G
OH
208000000X
Pediatrics Physician
Primary
35.056893
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000271433
ANTHEM BCBS
OH
05
—
0735459
—
OH
05
—
4433656
—
MI
01
—
810547599052
CARESOURCE
OH
01
—
930120439
RAILROAD MEDICARE
OH
Enumeration date
06/16/2005
Last updated
01/31/2013
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