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Individual

DR. THOMAS LESLIE PALLONE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-5793
(410) 328-0248
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-5793
(410) 328-0248

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
D30688
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000899701
DE
05
0211860000
WV
05
022078400
DC
05
350611800
MD
01
535915-01
BLUE CROSS/BLUE SHIELD
MD
05
5841135
VA
Enumeration date
06/13/2006
Last updated
03/11/2008
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