Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Charles J. Mallo, DO

Individual provider Psychiatry Physician · NPI 1063611788

Dr. Charles J. Mallo, DO is a Psychiatry in Portland, Maine. Qualified in 2007, 19 years ago. Practices with Mainehealth, a 2,615-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Maine.

Years since qualifying
19
Licensed in
ME
In the registry since
2007
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

216 Vaughan St
Portland, ME 04102-3204
Phone: (207) 662-2221
Fax: (207) 810-2367
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence DO2378 (ME)

Record details

NPI number1063611788
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJuly 12, 2007
Last updated in NPPESAugust 16, 2023
Certification dateAugust 16, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Mainehealth — 2615 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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