Individual
CARLOS J GALLEGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-6665
(937) 395-6668
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.130222
OH
207R00000X
Internal Medicine Physician
MD60310185
WA
207SG0201X
Clinical Genetics (M.D.) Physician
MD60310185
WA
208M00000X
Hospitalist Physician
Primary
35.130222
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0206321
—
OH
01
—
P01696169
RR PTAN WVH
WA
Enumeration date
05/10/2007
Last updated
05/05/2023
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