Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD.33375 | AL |
NPI | 1134488174 |
---|---|
Provider Name | Ginger Gladden Medders |
First Address | Gadsden, AL 35901-5216 |
Second Address | Fort Payne, AL 35967-3700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2012 |
Last Update Date | 17/02/2021 |