=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235178856
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET ANN GALANES M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2006
-----------------------------------------------------
Last Update Date | 11/10/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60101 BODNAR BLVD SUITE 100B
-----------------------------------------------------
City | MISHAWAKA
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46544-9328
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 574-335-8500
-----------------------------------------------------
Fax | 574-335-0794
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 707 CEDAR ST STE 405
-----------------------------------------------------
City | SOUTH BEND
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46617-2059
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | 01042981A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------