Healthcare Provider Details

I. General information

NPI: 1235115619
Provider Name (Legal Business Name): PAULA ELIZABETH GALLOWAY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA ELIZABETH ANDERSON DO

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 HOSPITAL PLZ SUITE 102
WESTON WV
26452-8552
US

IV. Provider business mailing address

66 HOSPITAL PLZ SUITE 102
WESTON WV
26452-8558
US

V. Phone/Fax

Practice location:
  • Phone: 304-269-6004
  • Fax:
Mailing address:
  • Phone: 304-269-6004
  • Fax: 304-269-6026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number34007682
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO0000001955
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number6118
License Number StateAK
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number2666
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: