Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 008456 | ME |
NPI | 1134142227 |
---|---|
Provider Name | Anglea C Gilladoga |
First Address | Bangor, ME 04401-6630 |
Second Address | Bangor, ME 04401-6630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B86706 | (02) | ME |