MEDICARE: SEAN GALLAGHER D.O.

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	2085R0202X	Diagnostic Radiology Physician	34.014449	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	34.014449	OTHER	OH	STATE MEDICAL BOARD
2	58.007098	OTHER	OH	STATE MEDICAL BOARD

General Provider Information

NPI Number	:	1891180329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN GALLAGHER D.O.

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE # L10
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-1423
Country	:	US
Telephone Number	:	216-296-3737
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE # A21
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-1423
Country	:	US
Telephone Number	:	216-296-3737
Fax Number	:

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

Provider Enumeration Date	:	04/01/2015
Last Update Date	:	06/02/2020

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Directions to “ SEAN GALLAGHER D.O.” Practice Location

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