Healthcare Provider Details

I. General information

NPI: 1003837717
Provider Name (Legal Business Name): JOHN PATRICK GALEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 01/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7870W US HIGHWAY 2
MANISTIQUE MI
49854-8992
US

IV. Provider business mailing address

7870W US HIGHWAY 2
MANISTIQUE MI
49854-8992
US

V. Phone/Fax

Practice location:
  • Phone: 906-341-2153
  • Fax: 906-341-3299
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number17002
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: