MEDICARE: HERMAN W. PALAT 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
1	207Q00000X	Family Medicine Physician	OS002817L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	080104544	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	102999	OTHER	PA	PERSONAL CHOICE
3	102999	OTHER	PA	HIGHMARK BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	1026493	OTHER	PA	KEYSTONE MERCY
6	1230775	OTHER	PA	CIGNA
7	1591636	OTHER	PA	FIRST HEALTH
8	1820868	OTHER	PA	PHCS
9	00656690-02	OTHER	PA	AMERICHOICE
10	0058030000	OTHER	PA	IBC,KEYSTONE
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	10236	OTHER	PA	HEALTH PARTNERS
14	1481905	OTHER	PA	UNITED HEALTHCARE
15	2995	OTHER	PA	CLEAR CARE
16	19903	OTHER	PA	AETNA
17	PA0050878	OTHER	PA	TRICARE

General Provider Information

NPI Number	:	1679522957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERMAN W. PALAT D.O.

Provider Business Mailing Address
First Line	:	P. O. BOX 8500-6335
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19178-0001
Country	:	US
Telephone Number	:	215-807-8000
Fax Number	:	215-807-8235

Provider Business Practice Location Address
First Line	:	2451 GRANT AVE
Second Line	:	SUITE 1B
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-1004
Country	:	US
Telephone Number	:	215-671-8900
Fax Number	:	215-671-1272

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2006
Last Update Date	:	06/21/2010

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