Provider Demographics
NPI:1053602599
Name:GALLE, MEF DURRI (MD)
Entity type:Individual
Prefix:DR
First Name:MEF
Middle Name:DURRI
Last Name:GALLE
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 1:1825 HIGHWAY 34 E STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-6423
Mailing Address - Country:US
Mailing Address - Phone:888-341-3360
Mailing Address - Fax:
Practice Address - Street 1:1825 HIGHWAY 34 E STE 200
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-6423
Practice Address - Country:US
Practice Address - Phone:888-341-3360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2023-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD2075622083X0100X, 2083X0100X
GA59722174400000X
VA01012618112083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA059722OtherGEORGIA MEDICAL BOARD