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General NPI Number Information
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NPI Number | 1609970821
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Entity Type | Individual
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Provider Name | CHRISTIAN EDWARD PALETTA MD
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Gender | Male
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 1310 SOUTHERN AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20032-4623
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Country | US
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Telephone | 202-574-7222
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Fax | 202-574-7227
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Provider Business Mailing Address
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Address Line | 5220 BELFORT RD SUITE 130
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City | JACKSONVILLE
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State | FL
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Zip | 32256-6017
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Country | US
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Telephone | 904-446-3756
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | R1G65
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD043797
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License Number State | DC
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