MEDICARE: DR. KENNETH B GALLMORE II D.O.

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	207R00000X	Internal Medicine Physician	5101013600	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	700F314390	OTHER	MI	BLUE SHIELD
2	700H219150	OTHER	MI	BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124004817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH B GALLMORE II D.O.

Provider Business Mailing Address
First Line	:	26901 BEAUMONT BLVD STE 3D
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	28050 GRAND RIVER AVE
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-5919
Country	:	US
Telephone Number	:	947-521-8000
Fax Number	:

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	02/14/2022

Similar Medicare Providers

1720490543 — ALEXANDER COLEN D.O
Practice Location Address:

28050 GRAND RIVER AVE , ZIEGER ADMIN & EDUC BUILDING
FARMINGTON HILLS, MI
48336-5919

Practice Phone: 248-471-8822
Practice Fax:

1285676460 — BOTSFORD ANESTHESIOLOGISTS, PC
Practice Location Address:

28050 GRAND RIVER AVE
FARMINGTON HILLS, MI
48336-5919

Practice Phone: 248-471-8720
Practice Fax:

1093389967 — DR. NICHOLAS RUNGE DO
Practice Location Address:

28050 GRAND RIVER AVE
FARMINGTON HILLS, MI
48336-5919

Practice Phone: 947-521-8000
Practice Fax:

1003811662 — DR. JYOTHSNA YALAVARTHI MD
Practice Location Address:

28050 GRAND RIVER AVE
FARMINGTON HILLS, MI
48336-5919

Practice Phone: 734-464-0887
Practice Fax: 734-402-0254

1750351516 — JEROME WILBORN M.D.
Practice Location Address:

28050 GRAND RIVER AVE
FARMINGTON HILLS, MI
48336-5919

Practice Phone: 734-464-0887
Practice Fax: 734-402-0254

1164490926 — DR. SANDOR ROBERT TERNER DO
Practice Location Address:

28050 GRAND RIVER AVE , BOTSFORD GENERAL HOSPITAL ANESTHESIA DEPT
FARMINGTON HILLS, MI
48336-5919

Practice Phone: 616-364-4200
Practice Fax: 616-364-7347

Directions to “ DR. KENNETH B GALLMORE II D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.