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Individual

MARTIN ROBERT GALLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1000 COWLES CLINC WAY STE A-100, GREENSBORO, GA 30642-5286
(706) 418-5778
Mailing address
21202 OWENS RD STE 201, MOKENA, IL 60448-2001
(779) 334-0010
(779) 334-0011

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036076016
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036076016
IL
01
P00694794
RR MEDICARE
IL
Enumeration date
08/17/2006
Last updated
07/07/2021
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