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NPI Code Detail

MEDICARE: PETER THOMAS GALANTICH MD

MEDICARE: PETER THOMAS GALANTICH 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
1207Y00000XOtolaryngology Physician0101044676VA

General Provider Information

NPI Number : 1457321515
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER THOMAS GALANTICH MD
Provider Business Mailing Address
First Line : 856 J CLYDE MORRIS BLVD
Second Line : SUTIE A
City : NEWPORT NEWS
State : VA
Zip : 23601-1318
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 895 MIDDLE GROUND BLVD
Second Line : SUITE 152
City : NEWPORT NEWS
State : VA
Zip : 23606-4250
Country : US
Telephone Number : 757-599-5505
Fax Number : 757-599-3618
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 11/27/2013

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Directions to “ PETER THOMAS GALANTICH MD” Practice Location

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