Basic Information
| Provider Information | |||||||||
| NPI: | 1336140813 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PALMER | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | H. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 NORLAND AVE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 EAST MAIN STREET | ||||||||
| Address2: | |||||||||
| City: | WAYNESBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 17268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177620552 | ||||||||
| FaxNumber: | 7177620808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2005 | ||||||||
| LastUpdateDate: | 05/30/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | MD021420E | PA | N | Other Service Providers | Specialist | 207RC0000X | MD021420E | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 0945155 | 05 | PA | MEDICAID | MD021420E | 01 | PA | MEDICAL LICENSE | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | AP2132948 | 01 | PA | DEA | OTHER |