Healthcare Provider Details

I. General information

NPI: 1154259638
Provider Name (Legal Business Name): ALAN ODELL PALMER JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10909 RHODENDA AVE
UPPER MARLBORO MD
20772-4727
US

IV. Provider business mailing address

10909 RHODENDA AVE
UPPER MARLBORO MD
20772-4727
US

V. Phone/Fax

Practice location:
  • Phone: 301-379-2631
  • Fax:
Mailing address:
  • Phone: 301-379-2631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: