Provider Demographics
NPI:1275537722
Name:PALLONE, MICHAEL N (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:N
Last Name:PALLONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CADMUS LN STE 210
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4094
Mailing Address - Country:US
Mailing Address - Phone:410-822-8550
Mailing Address - Fax:
Practice Address - Street 1:500 CADMUS LN STE 210
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4094
Practice Address - Country:US
Practice Address - Phone:410-822-8550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD057226L208000000X
MDD90260208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017499440007Medicaid
027187Medicare ID - Type Unspecified
PA0017499440004Medicaid