Healthcare Provider Details

I. General information

NPI: 1437109949
Provider Name (Legal Business Name): MICHAEL T GALLOWAY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD 400 STE 102
SALINAS CA
93906
US

IV. Provider business mailing address

1441 CONSTITUTION BLVD STE 102
SALINAS CA
93906-3126
US

V. Phone/Fax

Practice location:
  • Phone: 831-796-1630
  • Fax: 831-754-1660
Mailing address:
  • Phone: 831-796-1630
  • Fax: 831-754-1660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberG76202
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: