Provider Demographics
NPI:1508819467
Name:SINGLETON GASTON, GLORIA (MD)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:
Last Name:SINGLETON GASTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GLORIA
Other - Middle Name:
Other - Last Name:SINGLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2550 WINDY HILL RD SE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8665
Mailing Address - Country:US
Mailing Address - Phone:770-933-0288
Mailing Address - Fax:770-951-1663
Practice Address - Street 1:2550 WINDY HILL RD SE
Practice Address - Street 2:SUITE 101
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8665
Practice Address - Country:US
Practice Address - Phone:770-933-0288
Practice Address - Fax:770-951-1663
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA023505207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE57038Medicare UPIN