Provider Demographics
NPI:1922008747
Name:PALAZZO, MICHELLE DEANNE (MD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DEANNE
Last Name:PALAZZO
Suffix:
Gender:F
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:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-588-0328
Mailing Address - Fax:
Practice Address - Street 1:225 ABRAHAM FLEXNER WAY STE 700
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3868
Practice Address - Country:US
Practice Address - Phone:502-561-4263
Practice Address - Fax:502-561-4288
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC34965208200000X
IN01062440A2082S0105X
KY39636207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200860310Medicaid
KY7100018070Medicaid
IN218440UMedicare PIN
I15608Medicare UPIN
INP00399799Medicare PIN
DC014681M65Medicare PIN