Provider Demographics
NPI:1497835771
Name:GALLAGHER, MICHAEL T (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:T
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:435 S CRYSTAL ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1515
Mailing Address - Country:US
Mailing Address - Phone:406-496-3400
Mailing Address - Fax:406-496-3401
Practice Address - Street 1:435 S CRYSTAL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1515
Practice Address - Country:US
Practice Address - Phone:406-496-3400
Practice Address - Fax:406-496-3401
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8086207XX0801X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0019552Medicaid
MT000011741OtherBLUE CROSS BLUE SHIELD
MT0112266OtherMONTANA STATE IAB