MEDICARE: MRS. EMILY D PALMER 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	208000000X	Pediatrics Physician	0101231973	VA

General Provider Information

NPI Number	:	1881674430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY D PALMER MD

Provider Business Mailing Address
First Line	:	10400 EATON PL
Second Line	:	410
City	:	FAIRFAX
State	:	VA
Zip	:	22030
Country	:	US
Telephone Number	:	703-359-5160
Fax Number	:	703-383-9574

Provider Business Practice Location Address
First Line	:	2946 SLEEPY HOLLOW RD
Second Line	:	3B
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2003
Country	:	US
Telephone Number	:	703-534-1000
Fax Number	:	703-536-7763

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

Provider Enumeration Date	:	01/19/2006
Last Update Date	:	07/08/2007

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