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NPI Code Detail

MEDICARE: DR. DAVID R PALMER M.D.

MEDICARE: DR. DAVID R PALMER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician01043018AIN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00825407OTHERINR.R. MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4000000641094OTHERINANTHEM

General Provider Information

NPI Number : 1255303210
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID R PALMER M.D.
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1819 CAREW ST
Second Line : ATTENTION: POLLY BALOSKI
City : FORT WAYNE
State : IN
Zip : 46805-4705
Country : US
Telephone Number : 260-481-4810
Fax Number : 260-481-4883
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 10/17/2022

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Directions to “ DR. DAVID R PALMER M.D.” Practice Location

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