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NPI Code Detail

MEDICARE: DR. KIMBERLY MAZZEI GALLAGHER MD

MEDICARE:  DR. KIMBERLY MAZZEI GALLAGHER  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianC10005489DE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043256787
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY MAZZEI GALLAGHER MD
Provider Business Mailing Address
First Line : PO BOX 3012
Second Line :
City : WILMINGTON
State : DE
Zip : 19804
Country : US
Telephone Number : 800-456-4629
Fax Number : 302-224-2848
Provider Business Practice Location Address
First Line : 35141 ATLANTIC AVE UNIT 1
Second Line :
City : MILLVILLE
State : DE
Zip : 19967-6954
Country : US
Telephone Number : 302-537-3740
Fax Number : 302-537-3744
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2006
Last Update Date : 07/08/2010

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Directions to “ DR. KIMBERLY MAZZEI GALLAGHER MD” Practice Location

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