Healthcare Provider Details

I. General information

NPI: 1447239504
Provider Name (Legal Business Name): JAMES F GALLAGHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 06/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31519 WINTERPLACE PKWY SUITE 1
SALISBURY MD
21804-1884
US

IV. Provider business mailing address

31519 WINTERPLACE PKWY SUITE 1
SALISBURY MD
21804-1884
US

V. Phone/Fax

Practice location:
  • Phone: 410-546-2500
  • Fax: 410-546-5005
Mailing address:
  • Phone: 410-546-2500
  • Fax: 410-546-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0069525
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberC1-0009165
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: