Provider Demographics
NPI:1679527063
Name:PALMA, CLARO TESORO (MD)
Entity Type:Individual
Prefix:
First Name:CLARO
Middle Name:TESORO
Last Name:PALMA
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 1:2727 PACES FERRY RD SE STE 1-1100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6151
Mailing Address - Country:US
Mailing Address - Phone:470-271-3418
Mailing Address - Fax:
Practice Address - Street 1:822 INDUSTRIAL BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ELLIJAY
Practice Address - State:GA
Practice Address - Zip Code:30540-3804
Practice Address - Country:US
Practice Address - Phone:706-515-7030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA82720207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA42141730753OtherJOHN DEERE HEALTH INS PLA
IA52996OtherWELLMARK INS PLAN
IA0133629Medicaid
IA42141730753OtherJOHN DEERE HEALTH INS PLA
IA52996Medicare ID - Type Unspecified