Healthcare Provider Details

I. General information

NPI: 1376703868
Provider Name (Legal Business Name): TODD LOUIS GALDES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TODD L GALDES D.O.

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 04/02/2021
Certification Date: 04/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 W ROYAL DR
TRAVERSE CITY MI
49684-8965
US

IV. Provider business mailing address

4045 W ROYAL DR
TRAVERSE CITY MI
49684-8965
US

V. Phone/Fax

Practice location:
  • Phone: 248-766-8097
  • Fax: 231-935-0308
Mailing address:
  • Phone: 248-766-8097
  • Fax: 231-935-0308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number69117
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number5101017784
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: