Healthcare Provider Details

I. General information

NPI: 1669585436
Provider Name (Legal Business Name): VALERIE G PALMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 08/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 LINNAEAN ST NO. 1
CAMBRIDGE MA
02138-1611
US

IV. Provider business mailing address

26 LINNAEAN ST NO.1
CAMBRIDGE MA
02138-1611
US

V. Phone/Fax

Practice location:
  • Phone: 617-491-6171
  • Fax:
Mailing address:
  • Phone: 617-491-6171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number059293
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: