Provider Demographics
NPI:1295120194
Name:GALLAGHER, SEAN M (MD)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:M
Last Name:GALLAGHER
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 1:890 HIGH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4193
Mailing Address - Country:US
Mailing Address - Phone:614-540-7339
Mailing Address - Fax:614-540-7338
Practice Address - Street 1:890 HIGH ST STE 200
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4193
Practice Address - Country:US
Practice Address - Phone:614-540-7339
Practice Address - Fax:614-540-7338
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.132344208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics