Provider Demographics
NPI:1164465324
Name:PALOSAARI, DAVID E (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:PALOSAARI
Suffix:
Gender:M
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:PO BOX 3947
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89505-3947
Mailing Address - Country:US
Mailing Address - Phone:775-334-3450
Mailing Address - Fax:775-334-3417
Practice Address - Street 1:1155 MILL ST
Practice Address - Street 2:RENOWN REGIONAL MEDICAL CENTER PATH LAB
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1576
Practice Address - Country:US
Practice Address - Phone:775-334-3450
Practice Address - Fax:775-334-3417
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA43810207ZP0102X
UT170319-1205207ZP0102X
NV5606207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV201679105Medicaid
CAXPY144580Medicaid
22WCGSZ1AMedicare ID - Type Unspecified
CAXPY144580Medicaid