MEDICARE: ELIZABETH MARIE GALIK RN CRNP PHD

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	363L00000X	Nurse Practitioner	R121770	MD

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	:	1124028261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH MARIE GALIK RN CRNP PHD

Provider Business Mailing Address
First Line	:	6501 N CHARLES ST
Second Line	:	SHEPPARD PRATT, GIBSON BUILDING
City	:	BALTIMORE
State	:	MD
Zip	:	21204-6819
Country	:	US
Telephone Number	:	410-938-4981
Fax Number	:	410-938-5310

Provider Business Practice Location Address
First Line	:	6501 N CHARLES ST
Second Line	:	SHEPPARD PRATT, GIBSON BUILDING
City	:	BALTIMORE
State	:	MD
Zip	:	21204-6819
Country	:	US
Telephone Number	:	410-938-4981
Fax Number	:	410-938-5310

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	10/25/2012

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