Individual
DR. MANOLO GALLEGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
880 CANTON RD NE, SUITE 400, MARIETTA, GA 30060-7276
(770) 528-9788
(770) 420-2229
Mailing address
880 CANTON RD NE, SUITE 400, MARIETTA, GA 30060-7276
(770) 528-9788
(770) 420-2229
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036745
GA
207RN0300X
Nephrology Physician
Primary
036745
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000691182AB
—
GA
05
—
00691182E
—
GA
05
—
00691182F
—
GA
Enumeration date
09/30/2005
Last updated
03/22/2012
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