MEDICARE: DR. PATRICK ALTON GLADDING MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1760712517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK ALTON GLADDING MD

Provider Business Mailing Address
First Line	:	2409 LEE RD
Second Line	:	CLEVELAND HEIGHTS
City	:	CLEVELAND
State	:	OH
Zip	:	44118-4124
Country	:	US
Telephone Number	:	216-924-9099
Fax Number	:

Provider Business Practice Location Address
First Line	:	2409 LEE RD
Second Line	:	CLEVELAND HEIGHTS
City	:	CLEVELAND
State	:	OH
Zip	:	44118-4124
Country	:	US
Telephone Number	:	216-924-9099
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2009
Last Update Date	:	12/29/2009

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