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NPI Code Detail

MEDICARE: DR. HEATHER SUE GLADUE DO

MEDICARE: DR. HEATHER SUE GLADUE DO
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
1207RR0500XRheumatology Physician2015-01003NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10520906OTHERNCCIGNA
219EA6OTHERNCBCBS PPN
30520906OTHERNCCIGNA PROVIDER ID NUMBER

General Provider Information

NPI Number : 1790949642
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEATHER SUE GLADUE DO
Provider Business Mailing Address
First Line : 801 E MOREHEAD ST STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28202-3195
Country : US
Telephone Number : 704-342-0252
Fax Number : 980-533-7806
Provider Business Practice Location Address
First Line : 801 E MOREHEAD ST STE 100
Second Line :
City : CHARLOTTE
State : NC
Zip : 28202-3195
Country : US
Telephone Number : 704-342-0252
Fax Number : 980-533-7801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2008
Last Update Date : 06/10/2026

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Directions to “ DR. HEATHER SUE GLADUE DO” Practice Location

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