Individual
SPENCER WALTER GALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
400 MATTHEW ST, SUITE 401, MARIETTA, OH 45750-1644
(740) 374-2252
(740) 374-4974
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-4500
(740) 374-5887
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
01750
WV
363AM0700X
Medical Physician Assistant
Primary
50.003955
OH
363AM0700X
Medical Physician Assistant
5052
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0091459
—
OH
01
—
P01515012
RAILROAD MEDICARE - MHCPI
WV
Enumeration date
10/14/2011
Last updated
02/27/2017
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