Provider Demographics
NPI:1811024847
Name:PALMER, JOHN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:PALMER
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 1:136 FURMAN RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5038
Mailing Address - Country:US
Mailing Address - Phone:828-262-0060
Mailing Address - Fax:
Practice Address - Street 1:136 FURMAN RD
Practice Address - Street 2:SUITE 7
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5038
Practice Address - Country:US
Practice Address - Phone:828-262-0060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9701528207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891165FMedicaid
NC2259280CMedicare ID - Type Unspecified
NCG75944Medicare UPIN