MEDICARE: GALLAGHER PODIATRY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1043782543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALLAGHER PODIATRY PLLC

Provider Business Mailing Address
First Line	:	3515 WASHINGTON RD
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-3063
Country	:	US
Telephone Number	:	724-941-4330
Fax Number	:

Provider Business Practice Location Address
First Line	:	3515 WASHINGTON RD
Second Line	:
City	:	MC MURRAY
State	:	PA
Zip	:	15317-3063
Country	:	US
Telephone Number	:	724-941-4330
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	KEVIN F GALLAGHER
Credential	:	DPM
Telephone Number	:	724-610-9480

Provider Enumeration Date	:	12/20/2018
Last Update Date	:	12/20/2018

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