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General NPI Number Information
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NPI Number | 1124226006
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Entity Type | Individual
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Provider Name | DOUGLAS HAROLD GLEATON II M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 1315 ASHLEY RIVER RD
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City | CHARLESTON
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State | SC
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Zip | 29407-5315
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Country | US
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Telephone | 854-429-1175
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Fax | 843-695-9467
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Provider Business Mailing Address
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Address Line | PO BOX 13955
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City | CHARLESTON
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State | SC
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Zip | 29422-3955
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Country | US
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Telephone | 843-225-8320
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Fax | 843-225-3549
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 30062
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License Number State | SC
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