Gallego, Manolo
Gallego, Manolo is an sole proprietor health care provider with primary practice located at 880 Canton Rd Ne Suite 400, Marietta GA 30060-7276. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Nephrology. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Gallego, Manolo can be contacted via phone (770) 528-9788.Contact Information
Primary practice address
880 Canton Rd Ne Suite 400
Marietta GA 30060-7276
Phone: (770) 528-9788
Fax: (770) 420-2229
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 036745 | Georgia |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 036745 | Georgia |
Profile Details
| NPI number | 1275520793 |
|---|---|
| LBN Legal business name | Gallego, Manolo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Mar 22nd, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275520793 | NPPES |
| Georgia | MEDICAID | 00691182F | |
| Georgia | MEDICAID | 000691182AB | |
| Georgia | MEDICAID | 00691182E |
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