Provider Demographics
NPI:1689718892
Name:GALSTERER, EDWIN GEORGE (DO)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:GEORGE
Last Name:GALSTERER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4728
Mailing Address - Country:US
Mailing Address - Phone:989-753-7739
Mailing Address - Fax:
Practice Address - Street 1:1236 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4728
Practice Address - Country:US
Practice Address - Phone:989-753-7739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101006387207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1412939Medicaid
MIE31610Medicare UPIN
5733138Medicare ID - Type Unspecified