Provider Demographics
NPI:1710994082
Name:SEGALL, GEORGE M (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:M
Last Name:SEGALL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3801 MIRANDA AVE
Mailing Address - Street 2:NUCLEAR MEDICINE SERVICE 115
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1207
Mailing Address - Country:US
Mailing Address - Phone:650-858-3945
Mailing Address - Fax:650-849-0585
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:NUCLEAR MEDICINE SERVICE 115
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1207
Practice Address - Country:US
Practice Address - Phone:650-858-3945
Practice Address - Fax:650-849-0585
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG42984207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine