Healthcare Provider Details

I. General information

NPI: 1952359762
Provider Name (Legal Business Name): ANNABEL GALVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

933 E PIERCE ST
COUNCIL BLUFFS IA
51503-4626
US

IV. Provider business mailing address

14301 FNB PKWY STE 100
OMAHA NE
68154-7200
US

V. Phone/Fax

Practice location:
  • Phone: 402-361-5225
  • Fax: 402-391-1533
Mailing address:
  • Phone: 402-758-5233
  • Fax: 888-972-1672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number34530
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number21642
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: