Gladwin, Omar

Gladwin, Omar is an sole proprietor health care provider with primary practice located at 1220 Dewey Ave , Milwaukee WI 53213-2504. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Gladwin, Omar can be contacted via phone (414) 454-6600.

Contact Information

Primary practice address
1220 Dewey Ave Milwaukee WI 53213-2504
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 65113 Wisconsin

Profile Details

NPI number 1417213190
LBN Legal business name Gladwin, Omar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 6th, 2012
Last updated Jul 29th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417213190 NPPES
Wisconsin MEDICAID 100059833
Wisconsin MEDICAID 1417213190

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