Provider Demographics
NPI:1417991399
Name:PALOMAKI, JACOB F (MD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:F
Last Name:PALOMAKI
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 1:13956 ESTILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-1455
Mailing Address - Country:US
Mailing Address - Phone:216-521-4020
Mailing Address - Fax:
Practice Address - Street 1:13956 ESTILL DRIVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-1455
Practice Address - Country:US
Practice Address - Phone:216-521-4020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35030243207V00000X
OH35-030243207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA75528Medicare UPIN