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General NPI Number Information
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NPI Number | 1821433863
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Entity Type | Individual
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Provider Name | ERIC DANIEL GALLAGHER MD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2013
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Last Update Date | 10/19/2022
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Provider Practice Location Address
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Address Line | 17 BELMONT AVE STE 1
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City | BRATTLEBORO
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State | VT
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Zip | 05301
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Country | US
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Telephone | 802-251-8611
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Fax | 802-251-8419
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Provider Business Mailing Address
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Address Line | 17 BELMONT AVE
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City | BRATTLEBORO
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State | VT
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Zip | 05301-1718
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Country | US
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Telephone | 802-257-0341
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Fax | 802-251-8435
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 042.0014856
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License Number State | VT
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