Provider Demographics
NPI:1992774467
Name:GAL, ABRAHAM-RAMI (MD)
Entity type:Individual
Prefix:
First Name:ABRAHAM-RAMI
Middle Name:
Last Name:GAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:960 N 12TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233
Practice Address - Country:US
Practice Address - Phone:414-219-7653
Practice Address - Fax:414-219-7676
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI27522-020207UN0901X
WI27522207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30814200Medicaid
WI000840245Medicare PIN
WI30814200Medicaid
B52959Medicare UPIN
WI000846515Medicare PIN
WI000854475Medicare PIN
WI000804130Medicare PIN