Provider Demographics
NPI:1962498998
Name:GALLMAN, TODD A (MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:A
Last Name:GALLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:105 VINECREST CT # 600
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-8031
Mailing Address - Country:US
Mailing Address - Phone:864-227-2900
Mailing Address - Fax:864-227-6487
Practice Address - Street 1:105 VINECREST CT # 600
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-8031
Practice Address - Country:US
Practice Address - Phone:864-227-2900
Practice Address - Fax:864-227-6487
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17472207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC174723Medicaid
SC174723Medicaid
SC174723Medicaid
SC0102390OtherCAROLINA CARE PLAN
SCF937675111Medicare PIN