1265413249 NPI number — JOHN GALGANI M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265413249 NPI number — JOHN GALGANI M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

GALGANI

Provider First Name:

JOHN

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1265413249

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/08/2019

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 23340

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

SAINT LOUIS

Provider Business Mailing Address State Name:

MO

Provider Business Mailing Address Postal Code:

63156-3340

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

314-838-7912

Provider Business Mailing Address Fax Number:

314-921-6283

Provider First Line Business Practice Location Address:

637 DUNN RD STE 180

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

HAZELWOOD

Provider Business Practice Location Address State Name:

MO

Provider Business Practice Location Address Postal Code:

63042-1759

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

314-838-7912

Provider Business Practice Location Address Fax Number:

314-921-6283

Provider Enumeration Date:

11/08/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2080P0205X , with the licence number:  R7E82 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 208000000X , with the licence number: R7E82 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 4090132 . This is a "AETNA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 92215275 . This is a "BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 3300022 . This is a "UHC FLORISSANT ENDOCR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 100399 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 192023 . This is a "GHP FLORISSANT ENDOCR" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 1955V34311 . This is a "HEALTHCARE USA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 40195 . This is a "GHP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 1200166 . This is a "UHC" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 16502 . This is a "BCBS PCP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 40195 . This is a "GHP HMO FFS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
• Identifier: 431383893GAL . This is a "MERCY" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".