Individual
DR. KENNETH L. GALEWYRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6 13TH AVE E, POLSON, MT 59860-5315
(406) 883-5680
Mailing address
PO BOX 262, LIBERTY LAKE, WA 99019-0262
(406) 883-5680
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
24799
WI
207Q00000X
Family Medicine Physician
24799
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00496
MEDICARE GROUP
WI
01
—
080124104
PALMETTO GBA RR MEDICARE
—
01
—
1007586
PREFERRED ONE
—
05
—
30587900
—
WI
01
—
46Q67GA
BCBS MN
—
01
—
47190
MEDICARE GROUP
WI
Enumeration date
06/16/2005
Last updated
07/24/2015
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