Provider Demographics
NPI:1992866776
Name:GALLATIN, DAVID ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROBERT
Last Name:GALLATIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:985 PRINCE FREDERICK BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-3492
Mailing Address - Country:US
Mailing Address - Phone:410-535-2005
Mailing Address - Fax:410-535-4850
Practice Address - Street 1:10845 TOWN CENTER BLVD STE 204
Practice Address - Street 2:
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-2712
Practice Address - Country:US
Practice Address - Phone:410-535-2005
Practice Address - Fax:410-535-4850
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD51949207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD848993OtherOPTIMUM CH MDIPA PCP
DCC0410020OtherCAREFIRST OF DC
MD4461101OtherAETNA NON HMO
MD418100000Medicaid
MD2148224OtherAETNA PCP HMO
MD54587701OtherCAREFIRST OF MD
MD110149162OtherRAILROAD MEDICARE
MD110149162OtherRAILROAD MEDICARE
MDG46231Medicare UPIN