Provider Demographics
NPI:1790949642
Name:GLADUE, HEATHER SUE (DO)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:SUE
Last Name:GLADUE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1918 RANDOLPH RD STE 600
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-1198
Mailing Address - Country:US
Mailing Address - Phone:704-342-0252
Mailing Address - Fax:980-533-7806
Practice Address - Street 1:1918 RANDOLPH RD STE 600
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-1198
Practice Address - Country:US
Practice Address - Phone:704-342-0252
Practice Address - Fax:980-533-7801
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-01003207RR0500X
GA069814207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology