Provider Demographics
NPI:1578517835
Name:GALLIS, CHRISTINE M (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:GALLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:M
Other - Last Name:MENZEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:147 TOWNE SQUARE WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-3254
Mailing Address - Country:US
Mailing Address - Phone:412-942-1085
Mailing Address - Fax:412-942-0855
Practice Address - Street 1:147 TOWNE SQUARE WAY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-3254
Practice Address - Country:US
Practice Address - Phone:412-942-1085
Practice Address - Fax:412-942-0855
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047670L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001412779Medicaid
OH0940389Medicaid
PA001412779Medicaid
144126Medicare PIN
PAF44042Medicare UPIN