Gladwell, Michael A
Gladwell, Michael A is an individual health care provider with primary practice located at 3920 S 1100 E Suite 150, Salt Lake City UT 84124-1213. He recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as his primary health care specialty. Gladwell, Michael A can be contacted via phone (801) 262-7447.Contact Information
Primary practice address
3920 S 1100 E Suite 150
Salt Lake City UT 84124-1213
Phone: (801) 262-7447
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | D12291 | Minnesota |
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 347697-9924 | Utah |
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 54113 | Minnesota |
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 347697-1205 | Utah |
Profile Details
NPI number | 1639250673 |
---|---|
LBN Legal business name | Gladwell, Michael A |
Credentials | D.M.D., MD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 18th, 2006 |
Last updated | Apr 14th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1639250673 | NPPES |
Wisconsin | MEDICAID | 33828100 | |
Wisconsin | MEDICAID | ENROLLED | |
Wisconsin | MEDICAID | 935190000 |
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