Individual
SCOTT MICHAEL KALLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
705 BLOOMFIELD AVE, SUITE 101, BLOOMFIELD, CT 06002-2479
(860) 286-0444
(860) 286-0464
Mailing address
705 BLOOMFIELD AVE, SUITE 101, BLOOMFIELD, CT 06002-2479
(860) 286-0444
(860) 286-0464
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042001
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001420017
—
CT
Enumeration date
07/08/2005
Last updated
06/05/2013
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