Provider Demographics
NPI:1033524012
Name:GAL, SHAILI (MD)
Entity type:Individual
Prefix:
First Name:SHAILI
Middle Name:
Last Name:GAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6835 E CAMELBACK RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3119
Mailing Address - Country:US
Mailing Address - Phone:954-670-4964
Mailing Address - Fax:
Practice Address - Street 1:2250 W SOUTHERN AVE STE 102
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4736
Practice Address - Country:US
Practice Address - Phone:480-835-5532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18559022086S0122X
390200000X
AZ590562086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program