Provider Demographics
NPI:1285897702
Name:GALLAGHER, GARY WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:WILLIAM
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3621 SOUTH STATE STREET
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:1500 EAST MEDICAL CENTER DRIVE
Practice Address - Street 2:1ST FLOOR UNIVERSITY HOSPITAL ROOM 1B300
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5036
Practice Address - Country:US
Practice Address - Phone:734-936-9035
Practice Address - Fax:734-936-5520
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2013-07-26
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Provider Licenses
StateLicense IDTaxonomies
MI43010921602084N0400X, 390200000X, 2084N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine