Healthcare Provider Details
I. General information
NPI: 1225616535
Provider Name (Legal Business Name): DANIEL GALLAGHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/30/2021
Last Update Date: 06/20/2025
Certification Date: 06/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
NAVAL HOSPITAL GUANTANAMO BAY PSC 1005 BOX 110185
FPO AA
34009
US
IV. Provider business mailing address
NAVAL HOSPITAL GUANTANAMO BAY PSC 1005 BOX 110185
FPO AA
34009
US
V. Phone/Fax
- Phone: 757-458-2998
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 0101285665 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: