MEDICARE: PATRICK M GALLAGHER NP

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	RN178076	GA

General Provider Information

NPI Number	:	1427104520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK M GALLAGHER NP

Provider Business Mailing Address
First Line	:	10 REESE WAY
Second Line	:
City	:	AVONDALE ESTATES
State	:	GA
Zip	:	30002-1663
Country	:	US
Telephone Number	:	404-297-0604
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	404-712-7033
Fax Number	:

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

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	01/11/2026

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