Provider Demographics
NPI:1053358788
Name:GALANG, REDENTOR L (MD)
Entity type:Individual
Prefix:DR
First Name:REDENTOR
Middle Name:L
Last Name:GALANG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3267 S 16TH ST
Mailing Address - Street 2:OHIO BUILDING SUITE 209
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-4500
Mailing Address - Country:US
Mailing Address - Phone:414-389-3111
Mailing Address - Fax:414-389-3110
Practice Address - Street 1:3267 S 16TH ST
Practice Address - Street 2:OHIO BUILDING SUITE 209
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4500
Practice Address - Country:US
Practice Address - Phone:414-389-3111
Practice Address - Fax:414-389-3110
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI478872084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34636300Medicaid
WI00119-00119Medicare ID - Type UnspecifiedST. FRANCIS MEDICARE SEQU
WI34636300Medicaid
WI0063-00109Medicare ID - Type UnspecifiedSMH MEDICARE SEQUENCE NU
WIG95715Medicare UPIN