Provider Demographics
NPI:1942499132
Name:SAMUEL R GALITZER DPM PA
Entity Type:Organization
Organization Name:SAMUEL R GALITZER DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALITZER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-586-8818
Mailing Address - Street 1:8 CHAREN CT
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 CHAREN CT
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-3442
Practice Address - Country:US
Practice Address - Phone:301-219-2326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01349213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC037025300Medicaid
MDP00115396OtherRAILROAD MEDICARE
MD037025300Medicaid
5246030001OtherMEDICARE DME
MD331515100Medicaid
FLP00151404OtherRAIL ROAD MEDICARE
P00151404Medicare PIN
FL65167Medicare PIN
DC037025300Medicaid
MD331515100Medicaid
MDP00151404Medicare PIN
5246030001OtherMEDICARE DME
DC1587Medicare PIN