Healthcare Provider Details

I. General information

NPI: 1104813922
Provider Name (Legal Business Name): LEANDRO P GALANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 MAIN ST STE 2
BELPRE OH
45714-1615
US

IV. Provider business mailing address

407 MAIN ST STE 2
BELPRE OH
45714-1615
US

V. Phone/Fax

Practice location:
  • Phone: 740-315-5706
  • Fax: 740-388-1665
Mailing address:
  • Phone: 740-315-5706
  • Fax: 740-388-1665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10811
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35086100
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: