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General NPI Number Information
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NPI Number | 1033418850
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Entity Type | Organization
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Legal Business Name | MID-ATLANTIC MEDICAL SERVICES,PC
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Dates
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Enumeration Date | 03/18/2011
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 57 W 57TH ST SUITE #1107
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City | NEW YORK
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State | NY
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Zip | 10019-2802
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Country | US
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Telephone | 212-874-3384
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Fax | 212-874-0031
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Provider Business Mailing Address
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Address Line | 4702 W HIGHWAY 74
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City | MONROE
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State | NC
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Zip | 28110-8453
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Country | US
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Telephone | 212-874-3384
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Fax | 212-874-0031
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES PALMA
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Credential | MD
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Telephone | 212-874-3384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 170169-1
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License Number State | NY
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