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1548383086

NPI Code Detail

MEDICARE: FAULLIN PALETSKY M.D.

MEDICARE: FAULLIN PALETSKY 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
1	207R00000X	Internal Medicine Physician	ME92326	FL
2	208M00000X	Hospitalist Physician	MD28142	OR
3	207R00000X	Internal Medicine Physician	MD28142	OR
4	207R00000X	Internal Medicine Physician	D0077416	MD
5	208M00000X	Hospitalist Physician	ME92326	FL

General Provider Information

NPI Number	:	1548383086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FAULLIN PALETSKY M.D.

Provider Business Mailing Address
First Line	:	3181 SW SAM JACKSON PARK RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3011
Country	:	US
Telephone Number	:	503-494-1164
Fax Number	:	503-494-5502

Provider Business Practice Location Address
First Line	:	3181 SW SAM JACKSON PARK RD
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97239-3011
Country	:	US
Telephone Number	:	503-494-1164
Fax Number	:	503-494-5502

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	01/26/2026

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Directions to “ FAULLIN PALETSKY M.D.” Practice Location

Language	Start Address	Practice Location

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