Provider Demographics
NPI:1679255830
Name:PALUMBO, ALICE JOHANNA (RT (R) (MR))
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:JOHANNA
Last Name:PALUMBO
Suffix:
Gender:F
Credentials:RT (R) (MR)
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Mailing Address - Street 1:1945 CAROLINA TOWNE CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8002
Mailing Address - Country:US
Mailing Address - Phone:843-475-8910
Mailing Address - Fax:
Practice Address - Street 1:1625 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3891
Practice Address - Country:US
Practice Address - Phone:866-774-6350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC2471C3402X, 2471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging
No2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography