Individual
BRADLEY C GALLAGHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Mailing address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 252-1670
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9773
MN
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
0762
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-23344
MEDICA #
MN
01
—
1033361
PREFERRED ONE #
MN
01
—
171217
UCARE #
MN
01
—
646K8GA
BCBS #
MN
01
—
HP40921
HEALTHPARTNERS #
MN
Enumeration date
06/16/2006
Last updated
03/02/2025
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