Active NPI
Mark A Gallagher, D.O.
- Surgery Physician
- Tawas City, MI
National Provider Identifier
1164416954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MG010486
- Practice address
- 295 Maple St
Suite 200
Tawas City, MI 48763-9352 - Phone
- (989) 984-3788
- NPI assigned
- Sep 7, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MG010486 | MI | Primary |
Addresses
Primary practice location
295 Maple St
Suite 200
Tawas City, MI 48763-9352
Mailing address
295 Maple St
Suite 200
Tawas City, MI 48763-9352
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MG010486 | MI | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369267200000",
"number": "1164416954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "295 MAPLE ST",
"address_2": "SUITE 200",
"city": "TAWAS CITY",
"state": "MI",
"postal_code": "487639352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "295 MAPLE ST",
"address_2": "SUITE 200",
"city": "TAWAS CITY",
"state": "MI",
"postal_code": "487639352",
"telephone_number": "989-984-3788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER",
"first_name": "MARK",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-07",
"last_updated": "2013-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "MG010486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tawas City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.