Provider Demographics
NPI:1134107857
Name:PALMER, ADRIAN PADUREAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:PADUREAN
Last Name:PALMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ADRIAN
Other - Middle Name:MIRCEA
Other - Last Name:PADUREAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12701 COMMONWEALTH DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913
Mailing Address - Country:US
Mailing Address - Phone:239-768-0600
Mailing Address - Fax:
Practice Address - Street 1:12701 COMMONWEALTH DR
Practice Address - Street 2:SUITE 9
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913
Practice Address - Country:US
Practice Address - Phone:239-768-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47298207ZH0000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34399900Medicaid
WI162450012Medicare PIN
WIP00180106Medicare PIN
WI132700011Medicare PIN
WI017600040Medicare PIN
WI682300034Medicare PIN
H85825Medicare UPIN