| Doctor Name: | DR. NEIL S GLADSTONE |
| NPI Number: | 1073697801 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 016917 |
| Business Practice Address: | 81 Upper Riverdale Rd Suite 210 Riverdale, GA - 302742627 |
| Business Phone Number: | 7709961200 |
| Business Fax Number: | 7709077492 |
| Mailing Address: | Po Box 962380, RIVERDALE |
| State: | GA |
| Postal Code: | 302966921 |
| Phone Number: | 7709961200 |
| Fax Number: | 7709077492 |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 09/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | 016917 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |