Provider Demographics
NPI:1437133220
Name:GALANTE, REBECCA E (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:E
Last Name:GALANTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9660 WICKER AVENUE
Mailing Address - Street 2:
Mailing Address - City:ST JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-9487
Mailing Address - Country:US
Mailing Address - Phone:219-226-2203
Mailing Address - Fax:219-226-2235
Practice Address - Street 1:9307 CALUMET AVENUE
Practice Address - Street 2:STE 2A
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2892
Practice Address - Country:US
Practice Address - Phone:219-836-2274
Practice Address - Fax:219-844-6912
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01039908207R00000X
IN01039908A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100387070Medicaid
408110FMedicare ID - Type Unspecified
INE24431Medicare UPIN
E24431Medicare UPIN