Individual
KENNETH EDWARD GALLAGHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
441 N WABASH AVE, MARION, IN 46952-2612
(765) 662-4648
Mailing address
PO BOX 11588, FORT WAYNE, IN 46859-1588
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
01050309
IN
Other
Enumeration date
09/24/2006
Last updated
07/08/2007
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