Provider Demographics
NPI:1053307819
Name:GLADISH, SHERI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERI
Middle Name:
Last Name:GLADISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 CONOVER DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-1900
Mailing Address - Country:US
Mailing Address - Phone:937-746-8795
Mailing Address - Fax:937-746-7062
Practice Address - Street 1:333 CONOVER DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-1900
Practice Address - Country:US
Practice Address - Phone:937-746-8795
Practice Address - Fax:937-746-7062
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-073062207P00000X
GA063422207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2143899Medicaid
OH2143899Medicaid
GL4014155Medicare PIN