Provider Demographics
NPI:1790846442
Name:STAHLE, GALEN W (MD)
Entity Type:Individual
Prefix:
First Name:GALEN
Middle Name:W
Last Name:STAHLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:18300 MTKA BLVD., STE 210
Mailing Address - Street 2:
Mailing Address - City:DEEPHAVEN
Mailing Address - State:MN
Mailing Address - Zip Code:55391-3272
Mailing Address - Country:US
Mailing Address - Phone:952-404-9124
Mailing Address - Fax:952-404-9273
Practice Address - Street 1:18300 MTKA BLVD., STE 210
Practice Address - Street 2:
Practice Address - City:DEEPHAVEN
Practice Address - State:MN
Practice Address - Zip Code:55391-3272
Practice Address - Country:US
Practice Address - Phone:952-404-9124
Practice Address - Fax:952-404-9273
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
MN238482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry