Healthcare Provider Details

I. General information

NPI: 1144254426
Provider Name (Legal Business Name): DAVID GALBIS-REIG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 09/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 SPRING ST
RACINE WI
53405-1667
US

IV. Provider business mailing address

3801 SPRING ST
RACINE WI
53405-1667
US

V. Phone/Fax

Practice location:
  • Phone: 262-687-4011
  • Fax:
Mailing address:
  • Phone: 262-687-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number44863
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number44863
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: