MEDICARE: MICHAEL J. GALLAGHER 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	174400000X	Specialist	MD-023494-E	PA
2	207RX0202X	Medical Oncology Physician	MD023494E	PA
3	2085R0203X	Therapeutic Radiology Physician	MD 023494 E	PA
4	2085R0001X	Radiation Oncology Physician	MD023494E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598760431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J. GALLAGHER M.D.

Provider Business Mailing Address
First Line	:	100 N ACADEMY AVE
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-4903
Country	:	US
Telephone Number	:	570-271-6144
Fax Number	:	570-271-6578

Provider Business Practice Location Address
First Line	:	211 E 3RD ST
Second Line	:
City	:	LEWISTOWN
State	:	PA
Zip	:	17044-1712
Country	:	US
Telephone Number	:	717-242-7297
Fax Number	:	717-242-7741

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	08/25/2020

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