| Charles Galiwango, MD | |
|
1080 N Ellington Pkwy, Lewisburg, TN 37091-2227 | |
| (904) 805-1300 | |
| (904) 805-1302 |
| Full Name | Charles Galiwango |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 1080 N Ellington Pkwy, Lewisburg, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417900812 | NPI | - | NPPES |
| 4108860 | Other | TN | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 24890 (Tennessee) | Primary |
| Entity Name | Amg-southern Tennessee Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164789467 PECOS PAC ID: 5991765943 Enrollment ID: O20041013001206 |
| Entity Name | Southeastern Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356379382 PECOS PAC ID: 2466364997 Enrollment ID: O20050125000997 |
| Entity Name | Emergency Coverage Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427005008 PECOS PAC ID: 3072412592 Enrollment ID: O20050207000666 |
| Entity Name | Hospital Medicine Services Of Tennessee Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528433802 PECOS PAC ID: 9234432881 Enrollment ID: O20160114002673 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles Galiwango, MD Po Box 532734, Atlanta, GA 30353-2734 Ph: (904) 805-1300 | Charles Galiwango, MD 1080 N Ellington Pkwy, Lewisburg, TN 37091-2227 Ph: (904) 805-1300 |
Gary Swanson, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1080 N Ellington Pkwy, Lewisburg, TN 37091 Phone: 904-805-1300 Fax: 904-805-1302 | |
Sonnepal Venkat, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1080 N Ellington Pkwy, Lewisburg, TN 37091 Phone: 904-805-1300 Fax: 904-805-1302 | |
Jim T Harris, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1080 N Ellington Pkwy, Lewisburg, TN 37091 Phone: 931-359-6241 |