Healthcare Provider Details

I. General information

NPI: 1003090234
Provider Name (Legal Business Name): DR. DAVID PALMIERI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/24/2007
Last Update Date: 12/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 KING ST STE 300
ALEXANDRIA VA
22314-2747
US

IV. Provider business mailing address

1650 KING STREET SUITE300
ALEXANDRIA VA
22314
US

V. Phone/Fax

Practice location:
  • Phone: 703-836-0006
  • Fax: 703-836-0009
Mailing address:
  • Phone: 703-836-0006
  • Fax: 703-836-0009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number0401410439
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: