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General NPI Number Information
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NPI Number | 1417737610
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Entity Type | Organization
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Legal Business Name | PALM DIAGNOSTICS INC
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Dates
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Enumeration Date | 10/04/2023
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 5021 ROME RED WAY
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6847
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Country | US
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Telephone | 410-788-7256
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Fax | 443-636-5418
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Provider Business Mailing Address
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Address Line | 5021 ROME RED WAY
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-6847
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Country | US
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Telephone | 410-788-7256
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Fax | 443-636-5418
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Authorized Official
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Title or Position | OWNER
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Name | AUGUSTINE DILIM ILOANYA
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Credential |
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Telephone | 301-675-9824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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