Provider Demographics
NPI:1962403600
Name:GALOS, RICHARD SCOTT (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:SCOTT
Last Name:GALOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2690 GREENSBORO RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-8106
Mailing Address - Country:US
Mailing Address - Phone:276-666-6673
Mailing Address - Fax:276-666-7361
Practice Address - Street 1:2690 GREENSBORO RD
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-8106
Practice Address - Country:US
Practice Address - Phone:276-666-6673
Practice Address - Fax:276-666-7361
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101239218207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE40134Medicare UPIN