Healthcare Provider Details

I. General information

NPI: 1568551638
Provider Name (Legal Business Name): MICHAEL PALMA CASAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 NEAL ST. SUITE 200
COOKEVILLE TN
38501
US

IV. Provider business mailing address

1080 NEAL ST. SUITE 200
COOKEVILLE TN
38501
US

V. Phone/Fax

Practice location:
  • Phone: 931-520-1529
  • Fax: 931-372-2751
Mailing address:
  • Phone: 931-520-1529
  • Fax: 931-372-2751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number16949
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34601MD
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: