Healthcare Provider Details

I. General information

NPI: 1306881271
Provider Name (Legal Business Name): CLIFFORD MICHAEL GALANIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12200 ANNAPOLIS RD STE 320
GLENN DALE MD
20769-9182
US

IV. Provider business mailing address

12200 ANNAPOLIS RD STE 320
GLENN DALE MD
20769-9182
US

V. Phone/Fax

Practice location:
  • Phone: 301-218-3700
  • Fax: 301-218-3909
Mailing address:
  • Phone: 301-627-1835
  • Fax: 301-627-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0050819
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberD0050819
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: