Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35-057860 | OH |
N | 111NI0900X | Internist | 35-057860 | OH |
Y | 207RN0300X | Nephrologist | 35-057860 | OH |
NPI | 1053377960 |
---|---|
Provider Name | John Halm Galla |
First Address | Cincinnati, OH 45206-3700 |
Second Address | Cincinnati, OH 45219-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 26/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0742058 | (05) | OH |
64861974 | (05) | KY |
C76946 | (02) |