MEDICARE: HARWELL PALMER, DDS

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
1	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	260653	OTHER	NC	UNITED CONCORDIA
2	96581	OTHER	NC	BCBS NC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316032766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARWELL PALMER, DDS

Provider Business Mailing Address
First Line	:	617 LONG DRIVE
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379
Country	:	US
Telephone Number	:	910-997-5051
Fax Number	:	910-997-7942

Provider Business Practice Location Address
First Line	:	617 LONG DRIVE
Second Line	:
City	:	ROCKINGHAM
State	:	NC
Zip	:	28379-4313
Country	:	US
Telephone Number	:	910-997-5051
Fax Number	:	910-997-7942

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. EUGENE HARWELL PALMER
Credential	:	DDS
Telephone Number	:	910-997-5051

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/23/2015

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