Healthcare Provider Details

I. General information

NPI: 1912134487
Provider Name (Legal Business Name): RYAN MICHAEL PALMER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2009
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 S CLEVELAND AVE
WESTERVILLE OH
43081-1397
US

IV. Provider business mailing address

70 S CLEVELAND AVE
WESTERVILLE OH
43081-1397
US

V. Phone/Fax

Practice location:
  • Phone: 614-839-2128
  • Fax: 614-823-8881
Mailing address:
  • Phone: 614-839-2128
  • Fax: 614-823-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberP9238
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: