MEDICARE: DR. DONNA ROSE GALBREATH MD

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	207Q00000X	Family Medicine Physician	2756	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073502043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONNA ROSE GALBREATH MD

Provider Business Mailing Address
First Line	:	4201 TUDOR CENTRE DR
Second Line	:	# 320
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5904
Country	:	US
Telephone Number	:	907-729-8624
Fax Number	:	907-729-8607

Provider Business Practice Location Address
First Line	:	4320 DIPLOMACY DR
Second Line	:	SUITE 2630
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5925
Country	:	US
Telephone Number	:	907-729-8624
Fax Number	:	907-729-8607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	12/05/2012

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