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General NPI Number Information
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NPI Number | 1326468992
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Entity Type | Organization
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Legal Business Name | TONY PALMER, MD, PLLC
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Dates
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Enumeration Date | 04/23/2014
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Last Update Date | 04/23/2014
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Provider Practice Location Address
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Address Line | 3078 NILES RD
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-8608
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Country | US
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Telephone | 269-588-0882
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Fax |
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Provider Business Mailing Address
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Address Line | 3078 NILES RD
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-8608
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Country | US
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Telephone | 269-588-0882
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY HOWARD PALMER
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Credential | M.D.
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Telephone | 269-588-0882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 4301062392
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License Number State | MI
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