Provider Demographics
NPI:1093772873
Name:PALMER, ROBERT M (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:PALMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-7040
Mailing Address - Fax:757-446-7049
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-7040
Practice Address - Fax:757-446-7049
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101248970207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAPAROtherFIRST HEALTH COMMERCIAL/COVENTRY HEALTH/SOUTHERN HEALTH
VAPAROtherCORVEL
VA-022OtherTRICARE
VA1093772873Medicaid
VAPAROtherVIRGINIA HEALTH NETWORK
VAPAROtherAETNA
VAPAROtherCIGNA
VAPAROtherVIRGINIA PREMIER HEALTH PLAN
VA421219OtherANTHEM
VAPAROtherUSA MANAGED CARE
NC5916743Medicaid
VA10073652OtherOPTIMA HEALTH
VAPAROtherMULTIPLAN
VAPAROtherUNITED HEALTHCARE/MAMSI
VAPAROtherVIRGINIA PREMIER HEALTH PLAN
VAVAA104436Medicare PIN