Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 5101017784 | MI |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 69117 | GA |
NPI | 1376703868 |
---|---|
Provider Name | Dr. Todd Louis Galdes |
First Address | Traverse City, MI 49684-8965 |
Second Address | Traverse City, MI 49684-8965 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2008 |
Last Update Date | 02/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
M00980032 | (02) | MI |