Provider Demographics
NPI:1225035397
Name:GALEA, PETER PAUL (DMP)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:PAUL
Last Name:GALEA
Suffix:
Gender:M
Credentials:DMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14555 LEVAN RD
Mailing Address - Street 2:STE E302
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5083
Mailing Address - Country:US
Mailing Address - Phone:734-591-6612
Mailing Address - Fax:734-591-6625
Practice Address - Street 1:14555 LEVAN RD
Practice Address - Street 2:STE E302
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5083
Practice Address - Country:US
Practice Address - Phone:734-591-6612
Practice Address - Fax:734-591-6625
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901001911213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4321195Medicaid
MIU84806OtherHEALTH ALLIANCE PLAN
MI000000004202OtherCARE CHOICES
MI104551200OtherUS DEP
MI135686OtherPREFERRED CHOICES
MIP0820103OtherMCARE
MI480033538OtherRAILROAD MEDICARE
MI000000004202OtherCAPE
MIP0820103OtherMCARE
MI104551200OtherUS DEP