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Individual

RANDY A GALLAGHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
78 MEDICAL CENTER DR, FISHERSVILLE, VA 22939-2332
(540) 932-4465
Mailing address
PO BOX 32849, DEPT 274, CHARLOTTE, NC 28232-2849
(540) 932-4465

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0102036946
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006025684
VA
05
010347564
VA
01
249833
BLUE SHIELD
VA
01
P00385724
RR MEDICARE
VA
Enumeration date
05/20/2006
Last updated
03/07/2023
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