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General NPI Number Information
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NPI Number | 1871669960
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Entity Type | Individual
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Provider Name | PATRICK WILLIAM PALUMBO MD, AAPS
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 8206 LEESBURG PIKE STE 401
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City | VIENNA
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State | VA
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Zip | 22182-2614
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Country | US
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Telephone | 703-356-5666
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Fax |
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Provider Business Mailing Address
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Address Line | 334 ELDEN ST
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City | HERNDON
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State | VA
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Zip | 20170-4818
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Country | US
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Telephone | 571-665-4000
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101044923
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101044923
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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