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Individual

DION GALLANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8200 CONSTITUTION PL NE STE A, PMG KASEMAN FAMILY HEALTHCARE, ALBUQUERQUE, NM 87110-7647
(505) 291-2402
(505) 291-2599
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2001195
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
96457333
NM
Enumeration date
08/01/2006
Last updated
07/15/2008
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