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General NPI Number Information
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NPI Number | 1134142227
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Entity Type | Individual
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Provider Name | ANGLEA C GILLADOGA MD
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 417 STATE ST SUITE 200
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City | BANGOR
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State | ME
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Zip | 04401-6630
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Country | US
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Telephone | 207-942-4108
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Fax | 207-973-8817
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Provider Business Mailing Address
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Address Line | 417 STATE ST SUITE 200
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City | BANGOR
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State | ME
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Zip | 04401-6630
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Country | US
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Telephone | 207-942-4108
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Fax | 207-973-8817
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 008456
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License Number State | ME
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