Provider Demographics
NPI:1578738605
Name:GALLAGHER, MAUREEN CECELIA (DO)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:CECELIA
Last Name:GALLAGHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:973 ELCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1967
Mailing Address - Country:US
Mailing Address - Phone:614-523-3750
Mailing Address - Fax:740-689-6759
Practice Address - Street 1:973 ELCLIFF DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1967
Practice Address - Country:US
Practice Address - Phone:614-523-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2016-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH340050912083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1959638Medicaid
OH4249241Medicare PIN