MEDICARE: DR. CLIFFORD MICHAEL GALANIS M.D.

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	2080A0000X	Pediatric Adolescent Medicine Physician	D0050819	MD
2	208000000X	Pediatrics Physician	D0050819	MD

General Provider Information

NPI Number	:	1306881271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLIFFORD MICHAEL GALANIS M.D.

Provider Business Mailing Address
First Line	:	6404 CROOM STATION RD
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-9512
Country	:	US
Telephone Number	:	301-627-1835
Fax Number	:	301-627-1836

Provider Business Practice Location Address
First Line	:	12200 ANNAPOLIS RD STE 320
Second Line	:
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9182
Country	:	US
Telephone Number	:	301-218-3700
Fax Number	:	301-218-3909

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

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	11/03/2020

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