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General NPI Number Information
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NPI Number | 1457388738
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Entity Type | Individual
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Provider Name | VAISHALI S GALA MD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 09/20/2016
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Provider Practice Location Address
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Address Line | 1715 DOUSMAN ST
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City | GREEN BAY
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State | WI
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Zip | 54303-3211
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Country | US
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Telephone | 920-496-4700
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Fax | 920-496-4705
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Provider Business Mailing Address
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Address Line | PO BOX 19070
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City | GREEN BAY
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State | WI
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Zip | 54307-9070
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Country | US
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Telephone | 920-496-4700
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2007025198
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 48393-20
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License Number State | WI
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