Provider Demographics
NPI:1518503879
Name:PALMER MEDICAL, PLLC
Entity Type:Organization
Organization Name:PALMER MEDICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-284-6204
Mailing Address - Street 1:25500 GODDARD RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3926
Mailing Address - Country:US
Mailing Address - Phone:313-914-2395
Mailing Address - Fax:313-914-2437
Practice Address - Street 1:34725 PALMER RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-4460
Practice Address - Country:US
Practice Address - Phone:734-589-8090
Practice Address - Fax:734-589-8089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty