Provider Demographics
NPI:1821063454
Name:PALERMO, DANIEL PETER (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PETER
Last Name:PALERMO
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 1:951 E MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:OH
Mailing Address - Zip Code:43907
Mailing Address - Country:US
Mailing Address - Phone:740-942-4631
Mailing Address - Fax:740-942-6301
Practice Address - Street 1:951 E MARKET STREET
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:OH
Practice Address - Zip Code:43907
Practice Address - Country:US
Practice Address - Phone:740-942-4631
Practice Address - Fax:740-942-6301
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV02490208600000X
OH35.122537208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2984623Medicaid
WV3810026536Medicaid
PA101442860Medicaid
OH2984623Medicaid
PA101442860Medicaid
OHH216481Medicare PIN