MEDICARE: ROBERTA F PALESTINE MD

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	207N00000X	Dermatology Physician	D0027831	MD
2	207NS0135X	Procedural Dermatology Physician	D0027831	MD

General Provider Information

NPI Number	:	1841285582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTA F PALESTINE MD

Provider Business Mailing Address
First Line	:	6410 ROCKLEDGE DR
Second Line	:	STE 201
City	:	BETHESDA
State	:	MD
Zip	:	20817-1809
Country	:	US
Telephone Number	:	301-530-8300
Fax Number	:	301-530-4638

Provider Business Practice Location Address
First Line	:	6410 ROCKLEDGE DR
Second Line	:	STE 201
City	:	BETHESDA
State	:	MD
Zip	:	20817-1809
Country	:	US
Telephone Number	:	301-530-8300
Fax Number	:	301-530-4638

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	02/02/2009

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Directions to “ ROBERTA F PALESTINE MD” Practice Location

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