Provider Demographics
NPI:1386678670
Name:GALLI, WILLIAM P (DO)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:P
Last Name:GALLI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:621 S NEW BALLAS RD
Mailing Address - Street 2:SUITE 4006B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8232
Mailing Address - Country:US
Mailing Address - Phone:314-251-6486
Mailing Address - Fax:314-251-4155
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-6486
Practice Address - Fax:314-251-4155
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-11-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARE2629207RP1001X
MO2011019868207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR140784003Medicaid
MO1386678670Medicaid
H19961Medicare UPIN
MO1386678670Medicaid
AR5L560Medicare PIN