Individual
DR. EMMANUEL L. GALLEGOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
405 W COUNTRY CLUB RD, ROSWELL, NM 88201-5209
(505) 491-2318
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2000-189
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000A1115
—
NM
Enumeration date
05/08/2006
Last updated
04/09/2019
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