MEDICARE: DR. MATTHEW RYAN GALLOWAY 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	207X00000X	Orthopaedic Surgery Physician	ME109696	FL

General Provider Information

NPI Number	:	1376610170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW RYAN GALLOWAY MD

Provider Business Mailing Address
First Line	:	3953 TAMPA RD STE 101
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3233
Country	:	US
Telephone Number	:	727-464-2867
Fax Number	:	727-464-2663

Provider Business Practice Location Address
First Line	:	3953 TAMPA RD STE 101
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-3233
Country	:	US
Telephone Number	:	727-464-2867
Fax Number	:	727-464-2663

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

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	12/08/2023

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