Provider Demographics
NPI:1902873458
Name:GALE, BRIAN D (DPM)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:GALE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 E CAPITOL AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-5620
Mailing Address - Country:US
Mailing Address - Phone:701-255-3338
Mailing Address - Fax:701-751-1471
Practice Address - Street 1:1733 E CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-2150
Practice Address - Country:US
Practice Address - Phone:701-255-3338
Practice Address - Fax:701-255-6706
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND029213ES0103X
ND29213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND17252Medicaid
ND0650330001Medicare PIN
ND0650330001Medicare NSC
NDN11829Medicare ID - Type UnspecifiedPROVIDER NUMBER
ND17252Medicaid