Individual
JORDAN GALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3000
Mailing address
144 STATE ST, PORTLAND, ME 04101-3776
(207) 879-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
018854
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326208760
—
ME
Enumeration date
06/10/2008
Last updated
04/04/2012
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