Healthcare Provider Details

I. General information

NPI: 1730609306
Provider Name (Legal Business Name): ROBERT COLEMAN PALM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2017
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE
ATLANTA GA
30322-3077
US

IV. Provider business mailing address

100 WOODRUFF CIR NE # 327
ATLANTA GA
30322-1020
US

V. Phone/Fax

Practice location:
  • Phone: 336-407-5243
  • Fax:
Mailing address:
  • Phone: 336-407-5243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberLL41021
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number89137
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number89137
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: