Individual
DR. EVAN DOV GALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 FRUIT ST, FOUNDERS 8, BOSTON, MA 02114-2621
(617) 643-8280
(617) 643-0683
Mailing address
55 FRUIT ST, FOUNDERS 8, BOSTON, MA 02114-2621
(617) 643-8280
(617) 643-0683
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
62519
CT
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
283531
MA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
62519
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004217099
—
CT
05
—
008087608
—
CT
Enumeration date
05/26/2016
Last updated
06/25/2020
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