MEDICARE: DR. RUTH K GALLATIN 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	207R00000X	Internal Medicine Physician	D0052089	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	33204	OTHER	KAISER
2	201232800	OTHER	FEDERAL WORKMANS COMP
3	2573274	OTHER	AETNA PPO
4	353172	OTHER	MAMSI
5	54643404	OTHER	BCBS
6	0001	OTHER	BCBS
7	129091	OTHER	AETNA HMO
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598758054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUTH K GALLATIN MD

Provider Business Mailing Address
First Line	:	2401 BRANDERMILL BLVD STE 220
Second Line	:
City	:	GAMBRILLS
State	:	MD
Zip	:	21054-1692
Country	:	US
Telephone Number	:	410-451-7214
Fax Number	:	410-451-7218

Provider Business Practice Location Address
First Line	:	2401 BRANDERMILL BLVD
Second Line	:	SUITE 220
City	:	GAMBRILLS
State	:	MD
Zip	:	21054-1690
Country	:	US
Telephone Number	:	410-451-7214
Fax Number	:	410-451-7218

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	04/26/2019

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Directions to “ DR. RUTH K GALLATIN MD” Practice Location

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