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Individual

DR. MARY ELLEN GALLAGHER

Active
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Individual

DR. MARY ELLEN GALLAGHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01235679
VA
208000000X
Pediatrics Physician
0123579
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
138532
ANTHEM BC/BS
VA
01
2130006
MAMSI/ALLIANCE PEDIATRIC
VA
01
2230846
GREAT WEST
VA
01
30-0212850
VIRGINIA HEALTH NETWORK
VA
01
3555510
AETNA HMO
VA
01
4130006
MAMSI/ALLIANCE INT.MED.
VA
01
5539725
CCN
VA
01
7668476
AETNA PPO
VA
01
J828-0001
CAREFIRST BC/BS
VA
Enumeration date
07/18/2005
Last updated
04/17/2013
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