Healthcare Provider Details

I. General information

NPI: 1134451511
Provider Name (Legal Business Name): PATRICIA GALLAGHER CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2010
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1933 W DENNEYS RD
DOVER DE
19904-4713
US

IV. Provider business mailing address

1933 W DENNEYS RD
DOVER DE
19904-4713
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-5111
  • Fax: 302-678-0547
Mailing address:
  • Phone: 302-678-5111
  • Fax: 302-678-0547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1003-10
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: