Provider Demographics
NPI:1568401081
Name:PALAZZARI, ADAM A (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:A
Last Name:PALAZZARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 EXEMPLA CIR
Mailing Address - Street 2:SUITE 420
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-3397
Mailing Address - Country:US
Mailing Address - Phone:720-565-6101
Mailing Address - Fax:720-545-0106
Practice Address - Street 1:300 EXEMPLA CIR
Practice Address - Street 2:SUITE 420
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3397
Practice Address - Country:US
Practice Address - Phone:720-565-6101
Practice Address - Fax:720-545-0106
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO44475207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO00671754Medicaid
CO00671754Medicaid