Individual
DR. STEPHEN R GALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3800 S NATIONAL AVE STE 160, SPRINGFIELD, MO 65807-5228
(000) 000-0000
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
2023013922
MO
2086S0129X
Vascular Surgery Physician
OS18918
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200122829
—
MO
Enumeration date
06/16/2015
Last updated
05/20/2024
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