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NPI Code Detail

MEDICARE: DR. BERNARD JOHN PALMA JR. D.O.

MEDICARE: DR. BERNARD JOHN PALMA JR. D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician34.006190OH
2208D00000XGeneral Practice Physician34.006190OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205872256
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BERNARD JOHN PALMA JR. D.O.
Provider Business Mailing Address
First Line : 615 ELSINORE PL STE 200
Second Line :
City : CINCINNATI
State : OH
Zip : 45202-1457
Country : US
Telephone Number : 513-834-7063
Fax Number :
Provider Business Practice Location Address
First Line : 5815 WESTBOURNE AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43213-1459
Country : US
Telephone Number : 513-834-7063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 12/28/2021

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