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General NPI Number Information
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NPI Number | 1336250042
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Entity Type | Individual
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Provider Name | BRIAN MICHAEL GALLAGHER PA
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | HWY 86 & TOPAWA RD
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City | SELLS
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State | AZ
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Zip | 85634
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Country | US
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Telephone | 520-295-2524
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Fax | 520-295-2615
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Provider Business Mailing Address
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Address Line | 3270 DOBSON DR
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City | BAY CITY
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State | MI
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Zip | 48706-1675
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Country | US
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Telephone | 989-450-5641
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601004365
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License Number State | MI
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