Provider Demographics
NPI:1124010491
Name:PALUMBO, ROBERT C (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:PALUMBO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 848269
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-8269
Mailing Address - Country:US
Mailing Address - Phone:610-973-1700
Mailing Address - Fax:610-973-1778
Practice Address - Street 1:250 CETRONIA ROAD
Practice Address - Street 2:SUITE 303
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9168
Practice Address - Country:US
Practice Address - Phone:610-973-6200
Practice Address - Fax:610-973-6546
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419522207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4363711OtherAETNA
PA77850OtherGEISINGER
PA821052OtherFIRST PRIORITY HEALTH
PAP2706695OtherOXFORD
PA200045565OtherRAILROAD MEDICARE
PA272222OtherAMERIHEALTH ADMINISTRATOR
PA4002706010OtherCIGNA
PA50001129OtherCAPITAL BLUE CROSS
PA0018972210001Medicaid
PA272222OtherBLUE SHIELD
PA0272222OtherKEYSTONE CENTRAL
PA0341516000OtherKEYSTONE EAST
PA77850OtherGEISINGER
PA4002706010OtherCIGNA