Individual
MR. GLYNN WARD GALLOWAY JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 HOSPITAL DR, EVANGELICAL COMMUNITY HOSPITAL, LEWISBURG, PA 17837-9314
(570) 522-2928
(570) 522-4171
Mailing address
PO BOX 101, MC EWENSVILLE, PA 17749-0101
(570) 713-9826
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN340134L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GA1400010
BLUE SHIELD
PA
Enumeration date
10/19/2005
Last updated
07/08/2007
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