MEDICARE: JOHN WALLACE GALBREATH 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	9600538	NC
2	207R00000X	Internal Medicine Physician	20605	WV

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	:	1891799433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN WALLACE GALBREATH MD

Provider Business Mailing Address
First Line	:	PO BOX 751803
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1803
Country	:	US
Telephone Number	:	336-718-0100
Fax Number	:	336-718-0120

Provider Business Practice Location Address
First Line	:	1381 WESTGATE CENTER DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-2934
Country	:	US
Telephone Number	:	336-718-0100
Fax Number	:	336-718-0120

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

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	09/11/2025

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