Provider Demographics
NPI:1497762330
Name:GALLINO, ROBERT A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:GALLINO
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 1:18101 PRINCE PHILIP DR STE 4100
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1514
Mailing Address - Country:US
Mailing Address - Phone:202-723-5524
Mailing Address - Fax:202-291-0512
Practice Address - Street 1:18109 PRINCE PHILIP DR
Practice Address - Street 2:STE 225
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832
Practice Address - Country:US
Practice Address - Phone:301-774-5810
Practice Address - Fax:301-774-0188
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD33067207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC023270700Medicaid
MD214381000Medicaid
DC409629Medicare PIN
MD214381000Medicaid
DCC15430Medicare PIN
MD00B880M37Medicare PIN
DC001317C29Medicare PIN
MD066MMedicare PIN
DC023270700Medicaid
MD060055581Medicare PIN