Provider Demographics
NPI:1073797528
Name:PALMER, MARIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:PALMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 HOUMA BLVD
Mailing Address - Street 2:#5
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2931
Mailing Address - Country:US
Mailing Address - Phone:504-888-5315
Mailing Address - Fax:
Practice Address - Street 1:3939 HOUMA BLVD
Practice Address - Street 2:#5
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2931
Practice Address - Country:US
Practice Address - Phone:504-888-5315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.0125212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA54571Medicare PIN
LAB65325Medicare UPIN