Individual
DAVID J GALLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
93 CAMPUS AVE, LEWISTON, ME 04240-6030
(207) 777-8400
Mailing address
324 GANNETT DR, STE 200, SOUTH PORTLAND, ME 04106-3270
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
011902
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310130099
—
ME
Enumeration date
12/01/2006
Last updated
02/14/2012
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