Healthcare Provider Details

I. General information

NPI: 1386617488
Provider Name (Legal Business Name): JAMES G GALLAGHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 02/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1469 8TH AVE
BETHLEHEM PA
18018-2256
US

IV. Provider business mailing address

1469 8TH AVE
BETHLEHEM PA
18018-2256
US

V. Phone/Fax

Practice location:
  • Phone: 484-526-7800
  • Fax: 484-526-7810
Mailing address:
  • Phone: 484-526-7800
  • Fax: 484-526-7810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD052310L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberMD052310L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: