Basic Information
| Provider Information | |||||||||
| NPI: | 1225147895 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GALE | ||||||||
| FirstName: | VIRGINIA | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 856 J CLYDE MORRIS BLVD STE A | ||||||||
| Address2: | |||||||||
| City: | NEWPORT NEWS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236011318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7573165800 | ||||||||
| FaxNumber: | 7575345190 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 HARRIS RD | ||||||||
| Address2: | EMERGENCY DEPT. | ||||||||
| City: | KILMARNOCK | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224823880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8044358000 | ||||||||
| FaxNumber: | 8044358543 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 11/25/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 0101226850 | VA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 0101226850 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 930106649 | 01 | VA | RR MEDICARE | OTHER | 5844045 | 05 | VA | MEDICAID | 216473 | 01 | VA | ANTHEM BCBS | OTHER |