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NPI Code Detail

MEDICARE: PETER GALLAGHER MD

MEDICARE: PETER GALLAGHER 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
12084P0800XPsychiatry Physician01059467AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000342636OTHERINANTHEM BC/BS

General Provider Information

NPI Number : 1174517841
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER GALLAGHER MD
Provider Business Mailing Address
First Line : 8400 LOUISIANA ST
Second Line :
City : MERRILLVILLE
State : IN
Zip : 46410-6385
Country : US
Telephone Number : 219-757-1928
Fax Number : 219-757-1950
Provider Business Practice Location Address
First Line : 8555 TAFT ST
Second Line :
City : MERRILLVILLE
State : IN
Zip : 46410-6123
Country : US
Telephone Number : 219-769-4005
Fax Number : 219-769-2508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 07/08/2007

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Directions to “ PETER GALLAGHER MD” Practice Location

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