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NPI Code Detail

MEDICARE: DR. EDMUND B PALOYAN M.D.

MEDICARE: DR. EDMUND B PALOYAN M.D.
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
1207RH0003XHematology & Oncology Physician4301085395MI
2207RX0202XMedical Oncology Physician4301085395MI
3207R00000XInternal Medicine Physician4301085395MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972509081
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDMUND B PALOYAN M.D.
Provider Business Mailing Address
First Line : 3900 HOLLYWOOD RD
Second Line : MARIE YEAGER CANCER CENTER
City : SAINT JOSEPH
State : MI
Zip : 49085-9149
Country : US
Telephone Number : 269-428-4411
Fax Number : 269-428-4422
Provider Business Practice Location Address
First Line : 3900 HOLLYWOOD RD
Second Line : MARIE YEAGER CANCER CENTER
City : SAINT JOSEPH
State : MI
Zip : 49085-9149
Country : US
Telephone Number : 269-428-4411
Fax Number : 269-428-4422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 03/28/2025

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