Provider Demographics
NPI:1043273451
Name:GALITZER, SAMUEL ROBERT (DPM)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:ROBERT
Last Name:GALITZER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CHAREN CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3442
Mailing Address - Country:US
Mailing Address - Phone:301-219-2326
Mailing Address - Fax:240-715-4695
Practice Address - Street 1:8 CHAREN CT
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3442
Practice Address - Country:US
Practice Address - Phone:301-586-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPO1000038213E00000X
FLPO 2100213E00000X
MD01349213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD012306400Medicaid
DC037025300Medicaid
5246030001OtherMEDICARE DME
MD135934Medicare ID - Type UnspecifiedMEDICARE
MD480003684Medicare PIN
FLP00151404Medicare ID - Type UnspecifiedRAILROAD MEDICARE
DC037025300Medicaid
FL65167Medicare PIN
MDU12411Medicare UPIN
MDG01737S01Medicare ID - Type Unspecified
FL65167Medicare ID - Type Unspecified
MD5246030001Medicare NSC
MDP00115396Medicare PIN
DCG01737Medicare PIN
DCG01737S01Medicare PIN
FLP00151404Medicare PIN
MD226309Medicare PIN
MD5246030001Medicare PIN
MD012306400Medicaid
MD013921R34Medicare PIN
MD135934Medicare PIN
MDP00115396Medicare ID - Type UnspecifiedRAILROAD MEDICARE