Provider Demographics
NPI:1841788734
Name:GALLOWAY, CHRISTIAN SMITH (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIAN
Middle Name:SMITH
Last Name:GALLOWAY
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:960 WOODSTOCK PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-4867
Mailing Address - Country:US
Mailing Address - Phone:770-667-4343
Mailing Address - Fax:770-772-0937
Practice Address - Street 1:960 WOODSTOCK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4867
Practice Address - Country:US
Practice Address - Phone:770-667-4343
Practice Address - Fax:770-772-0937
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2020-08-19
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Provider Licenses
StateLicense IDTaxonomies
NC0010-07988363A00000X
GA9773363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant