Healthcare Provider Details

I. General information

NPI: 1275891749
Provider Name (Legal Business Name): RYAN JOSEPH GALICA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2012
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3510 HIGHWAY 17 BYP N STE 325
MT PLEASANT SC
29466-8232
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-723-8823
  • Fax: 843-606-8059
Mailing address:
  • Phone: 888-472-0043
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number40468
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: