Provider Demographics
NPI:1598820797
Name:BALDWIN PEDIATRICS, GERARD P GALLE, M. D.
Entity Type:Organization
Organization Name:BALDWIN PEDIATRICS, GERARD P GALLE, M. D.
Other - Org Name:GERARD P GALLE, M. D.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:GALLE
Authorized Official - Suffix:SR
Authorized Official - Credentials:M D
Authorized Official - Phone:251-626-1861
Mailing Address - Street 1:PO BOX 336
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:AL
Mailing Address - Zip Code:36559-0336
Mailing Address - Country:US
Mailing Address - Phone:251-626-1861
Mailing Address - Fax:251-621-0540
Practice Address - Street 1:1290 MAIN ST
Practice Address - Street 2:C
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-8623
Practice Address - Country:US
Practice Address - Phone:251-626-1861
Practice Address - Fax:251-621-0540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9862208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5411047OtherAETNA PROVIDER NUMBER
AL51032304OtherBLUE CROSS BLUE SHIELD
AL5411047OtherAETNA PROVIDER NUMBER
AL5411047OtherAETNA PROVIDER NUMBER