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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639250673 NPPES
Wisconsin MEDICAID 33828100
Wisconsin MEDICAID ENROLLED
Wisconsin MEDICAID 935190000

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