Provider Demographics
NPI:1396447066
Name:GALVIN, PETER JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:JAMES
Last Name:GALVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1937 CHURCHILL DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-2212
Mailing Address - Country:US
Mailing Address - Phone:330-309-6796
Mailing Address - Fax:
Practice Address - Street 1:5170 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1022
Practice Address - Country:US
Practice Address - Phone:330-759-2511
Practice Address - Fax:330-675-5720
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program