Basic Information
| Provider Information | |||||||||
| NPI: | 1780685909 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GALVIN | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 RESEARCH PL STE 320 | ||||||||
| Address2: | |||||||||
| City: | NORTH CHELMSFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018632455 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9782561858 | ||||||||
| FaxNumber: | 9787887890 | ||||||||
| Practice Location | |||||||||
| Address1: | 20 RESEARCH PL | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | NORTH CHELMSFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018632454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787887307 | ||||||||
| FaxNumber: | 9787887890 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 11/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 78686 | MA | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 1780685909 | 01 | MA | CHAMPUS/TRICARE | OTHER | 1780685909 | 01 | MA | CIGNA | OTHER | 724674 | 01 | MA | TUFTS | OTHER | 980996 | 01 | MA | NETWORK | OTHER | AA116928 | 01 | MA | HPHC | OTHER | 1780685909 | 01 | MA | HEALTHSOURCE | OTHER | 0003665 | 01 | MA | NEIGHBORHOOD HEALTH PLAN | OTHER | 1780685909 | 01 | MA | BMC HEALTH NET | OTHER | 2636910 | 01 | MA | AETNA/US HEALTHCARE | OTHER | 30859 | 01 | MA | HEALTHY START | OTHER | J14473 | 01 | MA | BCBS | OTHER | 1780685909 | 01 | MA | GREAT WEST | OTHER | 1780685909 | 01 | MA | HEALTH PLANS INC | OTHER | 21087 | 01 | MA | FALLON | OTHER | 3124096 | 05 | MA | MEDICAID | 1780685909 | 01 | MA | HEALTH PARTNERS | OTHER | 1780685909 | 01 | MA | PREFERRED CARE OF NY | OTHER | 1780685909 | 01 | MA | PHCS | OTHER |